Two-pill combination less toxic than traditional treatment
Oncologists at Rush University Medical Center, Chicago, are studying what they believe may be the wave of the future for treating patients with advanced stage lung cancer: individualized targeted therapy--easier than chemotherapy, more specialized and less toxic.
Dr. Philip D. Bonomi, director of the Division of Hematology-Oncology at Rush and principal investigator of the study, is testing whether the combination of Tarceva (erlotinib) and Celebrex (celecoxib) can shrink tumors, relieve symptoms and offer improvement and survival for patients with stage IV lung cancer.
This is the one of the first efforts involving the combination of two targeted therapies in the treatment of advanced lung cancer without chemotherapy. Molecular profiles on each patient's tumor can be evaluated to see which patients might respond better.
"This therapy is being tested in patients who have already been treated with chemotherapy, have their disease progressing, and can provide tissue for profiling. We've recruited 10 patients so far, and expect to enroll 50 among the IV sites in the study."
Targeted therapy is based on the idea that a drug will attack its target without damaging other tissue. This combination therapy is better at focusing on abnormal signals that drive cancer cells, while sparing more of the body's healthier cells. By blocking essential pathways within tumor cells, the therapy works inside of the cell with minimal effects on noncancerous cells. The drugs reduce the cancer by blocking the process by which cancer cells divide, grow and spread.
Bonomi says that Tarceva "aims to slow cancer growth by blocking the action of a molecule called the epidermal growth factor receptor, or EGFR, a protein found in the cell membrane of some cells, but found at an abnormally high rate in cancer cells. The protein triggers cells to divide at an accelerated rate, which allows the abnormal cancer cells to grow and spread.
"We hope that doing molecular profiling on each patient's tumor will enable us to identify patients who are more likely to respond and to have a favorable response. We are looking to achieve tumor shrinkage with minimal side effects. We are hopeful that this type of research will provide a kinder, gentler, more effective therapy for lung cancer patients.
"This is the most exciting thing going on in lung cancer today. For the next two decades, this will be the wave of the future in treatment."
Patients with stage IV lung cancer who receive one course of chemotherapy have side effects of nausea, vomiting and can feel worn down. This two-pill combination is not chemotherapy, and it's less toxic to the body; patients do not experience nausea and vomiting. The targeted therapy can help some patients feel better and live longer. The side effects of these pills, which are less bothersome than that of traditional chemotherapy, include an acne-like rash and diarrhea.
Bonomi says that such seriously ill lung cancer patients might be expected to live four to six months without treatment. Tarceva, one of the combination drugs, has recently been reported to increase survival. In general, survival improvement for patients with advanced stage lung cancer have been modest- adding several months to longevity. "And while that doesn't seem like a lot of time, that may mean a lot to cancer patients planning to attend a graduation, anniversary or upcoming birthday in the next few months."
Over 170,000 new incidences of lung cancer are reported every year.
The other sites in the study are Rush North Shore, Skokie, Ill.; Northwestern Memorial Hospital, Chicago, and Vanderbilt University Medical Center, Nashville.
To enroll in the study, please call 312-942-5687.
Source: Eurekalert & othersLast reviewed: By John M. Grohol, Psy.D. on 21 Feb 2009
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Two roads diverged in a wood, and I--
I took the one less traveled by,
And that has made all the difference.
-- Robert Frost