Navigation Links
Gene Mutation Improves Response to Lung Cancer Drug

Finding supports worthiness of genetic screening

WEDNESDAY, Aug. 19 (HealthDay News) -- People with lung cancer who are screened for a genetic mutation and then given a drug called Tarceva, which is believed to work well with that mutation, live longer than those without the mutation who take the drug, new research has found.

According to the Spanish authors of a study in the Aug. 20 issue of the New England Journal of Medicine, this type of widespread screening is actually doable and could lead to better decisions about treatment.

"They proved that it is worthy to test patients for the [epidermal growth factor receptor gene] mutations, and that if you have the mutations you are going to do well," said Dr. Edgardo Santos, an assistant professor of medicine in the hematology and oncology section at the University of Miami's Sylvester Comprehensive Cancer Center. "If we are moving toward personalized medicine in the future, I think this is the way to go -- that patients be tested and use the drug if indicated."

People who have advanced non-small-cell lung cancer who also have certain mutations in the epidermal growth factor receptor gene (EGFR) tend to respond better to Tarceva and Iressa. Both of these drugs are tyrosine kinase inhibitors, which interfere with cancer cells' ability to multiply. Non-small-cell lung cancer is the most common form of lung cancer.

The researchers screened lung cancer samples from 2,105 people at 129 institutions in Spain for two different EGFR mutations.

Those with mutations (16.6 percent of the sample, considered a sizable proportion) were put on Tarceva. They survived a median of 14 months without progression of their disease and 27 months overall, more than twice as long as the rates seen in other treatment groups, Santos said. This was true regardless of whether Tarceva was given as first-line, second-line or third-line therapy.

"Basically, this highlights the fact that patients with EGFR mutations should, sometime during the course of their illness, get erlotinib [Tarceva]," said Dr. George Simon, director of thoracic oncology at Fox Chase Cancer Center in Philadelphia. "However, I think for reasons of quality of life and ease of administration and differences in toxicity profiles, it may still be preferable to give gefitinib [Iressa] first-line."

But a big question still to be worked out is why people still succumbed to the disease.

"They all had progressive disease, which basically means they had developed mechanisms of resistance," Simon said. "We need to study what were these mechanisms of resistance and how can we counteract them, developing methods of either prevention of the emergence of resistance or treatment once resistance has emerged."

A second study in the same issue of the journal, conducted in East Asia, found that Iressa worked better than a chemotherapy regimen of carboplatin-paclitaxel as a first-line treatment for nonsmokers and former light smokers who also had non-small-cell lung cancer.

Here again, people with the EGFR mutation responded better to Iressa.

At one year, almost 25 percent of those on Iressa had continued without a recurrence, compared with nearly 7 percent in the other group.

"Overall, patients who got gefitinib [Iressa] had a longer time from the start of treatment to the worsening of disease," Simon said. "And it appeared that the drug's benefit was primarily seen in patients with EGFR mutations."

Overall survival, however, did not differ between the two groups, probably because many people started the other type of treatment after they had relapsed on the first treatment, Simon said.

The study was funded by AstraZeneca, which makes Iressa.

"This basically confirmed what we have thought, that in selected populations [light smokers or those who never smoked], those testing positive for EGFR mutations will do much better in progression-free survival than if you put the patient on chemo," Santos said.

"For the first time in a selected population, you have a drug which can compete with systemic chemotherapy," he said. "There is a pill that matches systemic chemotherapy."

More information

The U.S. National Cancer Institute has more on non-small-cell lung cancer.

SOURCES: George Simon, M.D., director, thoracic oncology, Fox Chase Cancer Center, Philadelphia; Edgardo Santos, M.D., assistant professor, medicine, section of hematology and oncology, Sylvester Comprehensive Cancer Center, University of Miami; Aug. 20, 2009, New England Journal of Medicine

Copyright©2009 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Mutation in renin gene linked to inherited kidney disease
2. Genome of Leukemia Patient Reveals Common Mutations
3. Boehringer Ingelheim to Commence Phase III Study Investigating the Role of BIBW 2992 as First-Line Treatment for Non-Small Cell Lung Cancer (NSCLC) Patients with EGFR Mutations
4. Gene Mutation Could Be Key to Rare Blood Vessel Disease
5. Study Shows a Link Between Schizophrenia & Genetic Mutations
6. Gene Mutation Is Linked to Heart Muscle Disease
7. JNCI news brief: Hepatitis B virus mutations may predict risk of liver cancer
8. Cancer Researchers Link DICER1 Gene Mutation to Rare Childhood Cancer
9. New Cancer Drug Fights Tumors in Those With BRCA Mutations
10. Clarient Launches New Gene Mutation Test to Help Select Therapy for Non-Small Cell Lung Cancer
11. USC researchers identify DNA mutation that occurs at beginning point of T-cell lymphoma
Post Your Comments:
Related Image:
Gene Mutation Improves Response to Lung Cancer Drug
(Date:6/25/2016)... Oklahoma City, Oklahoma (PRWEB) , ... June 25, ... ... to helping both athletes and non-athletes recover from injury. Recently, he has implemented ... for the Oklahoma City area —Johnson is one of the first doctors to ...
(Date:6/24/2016)... ... 24, 2016 , ... Those who have experienced traumatic events may suffer from ... avenues, such as drug or alcohol abuse, as a coping mechanism. To avoid this ... coping following a traumatic event. , Trauma sufferers tend to feel a range of ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... Global law ... magazine’s 2016 Legal Elite. The attorneys chosen by their peers for this recognition are ... , Seven Greenberg Traurig Shareholders received special honors as members of this year’s Legal ...
(Date:6/24/2016)... , ... June 24, 2016 , ... People across the ... Genome magazine’s Code Talker Award, an essay contest in which patients and their families ... to be presented at the 2016 National Society of Genetic Counselors (NSGC) Annual Education ...
(Date:6/24/2016)... , ... June 24, 2016 , ... ... actively feeding the Frederick area economy by obtaining investment capital for emerging technology ... past 2½ years that have already resulted in more than a million dollars ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... Belgium , June 24, 2016 /PRNewswire/ ... announced the appointment of Dr. Edward Futcher ... a Non-Executive Director, effective June 23, 2016.Dr. Futcher ... and Nominations and Governance Committees.  As a non-executive ... provide independent expertise and strategic counsel to VolitionRx ...
(Date:6/23/2016)...  MedSource announced today that it has selected ... of choice.  This latest decision demonstrates MedSource,s commitment ... clients by offering a state-of-the-art electronic data capture ... as the EDC platform of choice in exchange ... has long been a preferred EDC platform by ...
(Date:6/23/2016)... , June 23, 2016 Any dentist who ... challenges of the current process. Many of them do not ... the technical difficulties and high laboratory costs involved. And those ... offer it at such a high cost that the majority ... Dr. Parsa Zadeh , founder of Dental ...
Breaking Medicine Technology: