Calling Dr. Google, Lung Cancer Specialist!
There have been some recent breakthroughs for certain types of lung cancer. The new shift in statistical research has been to match patients with therapies based on genetic abnormalities obvious in their particular cancer cells.
The first trick is pre-identifying patients who may be treated by defined genetic abnormalities.
To clarify how this procedure works, using the formula: patient plus genetic testing, plus treatment option relationship, let’s us look at an example.
The ALK Example:
1. A patient has been tested and is positive for a special type of lung cancer that is driven by rearrangement of the gene ALK.
2. It is known that the above patient will “derive significant benefit from the drug crizotinib.” Once you know that crizotinib was designed to target this abnormality, the logic of the research and the drug trials becomes crystal clear.
Scientists and researchers are trying to repeat the success of the crizotinib vs. ALK by matching different clinical study drugs “with specific subtypes of the disease, based on the presence of such “predictive biomarkers.”
The second trick is testing the new drugs in clinical trials. This is where “Dr. Google” comes in! Scientists and researchers and heads of lung cancer disease drug trials are on missions to find and enroll patients. The patients must have what might be “very rare molecular subtypes of a disease — one of the challenges is discovering enough needles in enough haystacks to prove the effectiveness of each biomarker-drug pairing.”
Research On The Internet–21st Century Style:
The University of Colorado Cancer Center is now enlisting the help of the internet to match patients with “biomarker-preselected clinical trials.”
How Does It Work?
First: Patients with advanced lung cancer answer onscreen questions.
Second: By telephone and internet, eligible patients consent to “permit a pre-existing biopsy sample of their lung cancer tissue to be shipped to CU Cancer.”
Third: There, at the University of Colorado Cancer Center, the biopsy will be subjected to trial-specific testing at the molecular level.
Fourth: The goal of the test is identify “patients who may have lung cancers driven by alterations in the gene FGFR1.” Such patients, whose tumors are FGFR1 positive and meet other trial screening criteria, will be offered treatment in a clinical trial at the CU Cancer Center.
Currently this means they will be given “the experimental FGFR1 inhibitor drug ponatinib.” Keep in mind that Ponatinib is already authorized for treating some blood cancers. It is the work done by CU laboratory scientists that suggests it might also be a powerful treatment option for “some specific molecular subtypes of lung cancer driven by, among other things, changes in the FGFR1 gene.”
Ross Camidge, MD, PhD, director of the thoracic oncology clinical program at the CU Cancer Center has explained that their methods to testing with the FGFR1 gene and Ponatinib are very different from what has been previously explored.
Drug Trials and scientific Research.
“Based on some really innovative work coming out of our own Specialized Program of Excellence in Lung Cancer, the tests we are employing in this trial seem to define a completely separate subtype of lung cancer — one that has really not been explored before. Now the challenge is in finding enough people whose cancers are positive for our biomarkers to prove whether the markers will predict for clinical benefit from ponatinib.”
The Take-Away!
Dr. Camidge and his team have actually built an infrastructure to create a nationwide molecular prescreening for the trial. They believe that internet awareness of medical knowledge has become so routine that, in Dr. Camidge’s words, “we thought we’d get Dr. Google to help us out.”
If you or some one you love has lung cancer, then you might already know that the Internet provides some very highly rated internet resources for lung cancer patients. We will tell you more about them in our next blog article, Part Two of Calling Dr. Google.