Genetic test sought to identify patients most likely to respond
A new anti-cancer agent, gefinitib (Iressa), recently received FDA approval for patients with advanced non-small cell lung cancer (NSCLC) after a series of clinical trials and an expanded access program led by researchers at Memorial Sloan-Kettering Cancer Center (MSKCC). The compound is designed to target and block the activity of the tyrosine kinase enzyme that signals the epidermal growth factor receptor (EGFR), telling the cancer cells to grow, divide, and spread. Gefinitib shrunk tumors in only ten percent of the NSCLC patients, although the enzyme is believed to be present and activated in most NSCLC patients. The results raised the questions - why wasnt the drug effective in more patients and could physicians predict who would respond to the drug?
The MSKCC researchers took a retrospective review of the characteristics of their patients in the three trials to analyze the features that were associated with sensitivity to the drug. They found that gefitinib worked best in individuals who had never smoked, had a type of non-small cell lung cancer called bronchioloalveolar cell carcinoma, and were female. Their results, published in the March 15 issue of the Journal of Clinical Oncology, may provide clues to the mechanisms involved in both the drug response and in possible tobacco-related genetic changes in lung cancer. This information could help physicians select those patients who will most benefit from the drug and also provide information that could lead to development of a molecular screen to grade expression and over-expression of EGFR tyrosine kinase inhibitor, much like one used to measure HER2 neu for breast cancer patients.
Joanne Nicholas | EurekAlert!
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