Patients with specific lung cancer respond to new targeted treatment

A study in the New England Journal of Medicine co-written by D. Ross Camidge, M.D., Ph.D., director of the lung cancer clinical program at University of Colorado Hospital (UCH) and the University of Colorado Cancer Center (UCCC), shows more than half of patients with a specific kind of lung cancer are responding positively to a treatment that targets the gene that drives their cancer.

The study shows 57 percent of patients with ALK-positive advanced non-small cell lung cancer responded partially or completely to a tablet called crizotinib, an investigational anaplastic lymphoma kinase (ALK) inhibitor. In some cases, the cancer becomes undetectable in body scans. The data is published in the journal's Oct. 28 issue.

"This study really supports the idea that we should always try to identify the patients that could benefit from a specific treatment in advance," Camidge said. "By looking at lung cancer at the molecular level, we were able to find the patients most likely to respond to the ALK inhibitor and put them in this trial.

"At the University of Colorado Hospital, we look after one of the largest groups of ALK positive lung cancer patients in the world. About one in 20 lung cancer patients are ALK positive. Most feel better within days of beginning the drug in the trial and many have returned to active lifestyles with their cancer under excellent control."

There were initially 82 ALK-positive lung cancer patients in the trial of the ALK inhibitor. ALK is believed to be a key driver of tumor development in some cancers.

Updated results from the study were presented at the recent 35th Congress of the European Society for Medical Oncology (ESMO) in Milan, Italy, reporting on a total of 113 patients and the impressive activity of the drug in these patients remained consistently high. The preliminary median progression-free survival (PFS), the time it takes for the cancer to first start to grow again, was 9.2 months.

"Initially the cancer melts away, but it's still there. And at some point, it usually figures out a way to get around this particular drug," Camidge said. "We need to keep looking for new developments so that when this happens, we can supplement or replace the crizotinib with other treatments to help keep the cancer under long-term control."

At the very least, Camidge said it is crucial for anyone diagnosed with lung cancer to get their tumor tested. Several commercially available tests are available but the definitive test that qualifies for entry into the study is only conducted in those centers with the trial. CU helped to develop these tests and many others for taking one disease – lung cancer – and revealing that it is, in fact, several different diseases at the molecular level. Each one of the diseases may need a different treatment.