Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Pre-treatment blood test could guide lung cancer therapy

06.06.2007
A multi-center team, led by Vanderbilt-Ingram Cancer Center investigators, has discovered a “signature” of proteins in the blood that predicts which non-small-cell lung cancer patients will live longer when they are treated with certain targeted cancer therapies.

The findings, published June 6 in the Journal of the National Cancer Institute, could one day help physicians decide which lung cancer patients to treat with drugs known collectively as EGF receptor tyrosine kinase inhibitors, a step forward in the era of personalized medicine.

“There’s a real clinical need to identify which patients will benefit from targeted therapies,” said David Carbone, M.D., Ph.D., Harold L. Moses Professor of Cancer Research at Vanderbilt-Ingram and the senior author of the study. “If our findings are confirmed, we will be able to use a simple and inexpensive blood test to select the most beneficial therapy for each patient.”

Targeted cancer therapies are the newest generation of anti-cancer drugs. In contrast to traditional chemotherapy, targeted therapies affect proteins and signaling pathways that are selectively activated in certain malignant cells and not in normal cells. But this selectivity makes these therapies effective only for the subset of patients whose tumors are “driven” by the targeted pathways.

The drawbacks of treating every patient with a targeted therapy include the expense of these drugs, the delay – for those who do not respond – in initiation of effective therapy, and the possibility that some patients will be harmed by the targeted therapy.

In the case of the EGF receptor tyrosine kinase inhibitors (TKIs) gefitinib (Iressa) and erlotinib (Tarceva), studies have demonstrated a survival benefit for 30 to 40 percent of lung cancer patients, but there has been no method for identifying these patients prior to treatment, Carbone said.

Investigators at Vanderbilt-Ingram, the University of Colorado in Aurora, Colo., and Biodesix Inc. in Steamboat Springs, Colo., with worldwide collaborators providing patient samples, set out to determine if a protein profile in the peripheral blood could predict clinical benefit – measured in terms of patient survival – to EGF receptor TKIs.

Using mass spectrometry, the researchers analyzed pre-treatment blood samples from 139 patients who had been treated with gefitinib (three patient cohorts in Italy and Japan), identified a pattern of eight proteins that was correlated with survival, and developed a prediction algorithm.

They then tested the algorithm in two additional groups of patients – 67 gefitinib-treated patients in Italy and 96 erlotinib-treated patients in a U.S. Eastern Cooperative Oncology Group protocol. At the time of the mass spectrometry analysis and classification, the researchers were “blind” to the survival status of the patients.

“We classified the patients as being either likely to benefit (“good”) or not likely to benefit (“poor”) from the TKIs,” Carbone said.

The method was highly successful in predicting a survival benefit. In the gefitinib-treated group, patients classified as “good” had a median survival of 207 days whereas those classified as “poor” had a median survival of 92 days. In the erlotinib-treated group, median survivals for “good” and “poor” groups were 306 and 107 days, respectively. The fact that the signature, which was developed from gefitinib-treated patients, also accurately predicted a survival benefit for erlotinib-treated patients buoys Carbone’s confidence in the algorithm, he said, since these two drugs share a common mechanism of action.

The method was not prognostic – it did not predict a survival benefit in three different control groups of patients treated with either chemotherapy or surgery alone.

The investigators are currently working with the Eastern Cooperative Oncology Group to develop a prospective national phase III trial that will test the prediction method’s clinical benefit in lung cancer patients who are just beginning treatment for advanced disease.

“This is a convincing set of data from multiple institutions and multiple cohorts of patients, and we’re excited to test the prediction algorithm in a prospective way,” Carbone said. “If it holds up, we will be able to separate patients into two groups – one that would benefit more from chemotherapy and the other from targeted TKIs – and treat them accordingly. The overall survival of the whole group of patients would be better by virtue of this biomarker-based test.”

Craig Boerner | EurekAlert!
Further information:
http://www.vanderbilt.edu

More articles from Health and Medicine:

nachricht Spanish scientists create a 3-D bioprinter to print human skin
24.01.2017 | Carlos III University of Madrid

nachricht Tracking movement of immune cells identifies key first steps in inflammatory arthritis
23.01.2017 | Massachusetts General Hospital

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Scientists spin artificial silk from whey protein

X-ray study throws light on key process for production

A Swedish-German team of researchers has cleared up a key process for the artificial production of silk. With the help of the intense X-rays from DESY's...

Im Focus: Quantum optical sensor for the first time tested in space – with a laser system from Berlin

For the first time ever, a cloud of ultra-cold atoms has been successfully created in space on board of a sounding rocket. The MAIUS mission demonstrates that quantum optical sensors can be operated even in harsh environments like space – a prerequi-site for finding answers to the most challenging questions of fundamental physics and an important innovation driver for everyday applications.

According to Albert Einstein's Equivalence Principle, all bodies are accelerated at the same rate by the Earth's gravity, regardless of their properties. This...

Im Focus: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

Breaking the optical bandwidth record of stable pulsed lasers

24.01.2017 | Physics and Astronomy

Choreographing the microRNA-target dance

24.01.2017 | Life Sciences

Spanish scientists create a 3-D bioprinter to print human skin

24.01.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>