Some Non-Small-Cell Lung Cancer Patients May Benefit from Targeted Drug Therapy

Treatment with the anaplastic lymphoma kinase (ALK) inhibiting drug crizotinib was found in a clinical trial to slow or even stop the growth of non-small-cell lung cancer in a group of patients whose tumors contained mutations in the ALK gene.

Investigators at the University of California, Irvine (USA) screened tumor samples from approximately 1500 patients with non–small-cell lung cancer for the presence of ALK rearrangements and identified 82 patients with advanced ALK-positive disease who were eligible for the clinical trial. Patients with ALK rearrangements tended to be younger than those without the rearrangements did, and most of the patients had little or no exposure to tobacco and had adenocarcinomas.

The patients were treated with 250 mg crizotinib twice daily in 28-day cycles. Over the course of the study, the patients were assessed for adverse events and response to therapy.

Results published in the October 28, 2010, issue of the New England Journal of Medicine (NEJM) revealed that tumors disappeared or shrank in 57% of the patients. Tumors ceased growing in another 33%. These results show distinct improvement over the response rate to the current standard of care for advanced non-small-cell lung cancer, which is about 15%. Treatment with the drug caused mild gastrointestinal side effects.

"For the majority of patients, the treatment right now is chemotherapy plus targeted therapy in those eligible,” said contributing author Dr. Ignatius Ou, assistant clinical professor of hematology and oncology at the University of California, Irvine. "In the future, with the advance of personalized medicine, we hope to be able to identify specific genetic change in the lung cancer and treat patients with specific inhibitors that can improve survival rates and quality of life.”

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