By: Laurie Edwards for Medtech1
Considering lung cancer kills more Americans each year than breast, prostate and colorectal cancer combined and has just a 15 percent survival rate, any progress in terms of treatment therapies is a big deal. Fortunately, researchers at Duke University have extremely promising news for lung cancer patients.
Duke researchers have developed the first-ever genomic test that predicts which early-stage patients will require chemotherapy and which ones can avoid the toxic treatment. Since the new test recommends chemotherapy for patients who are advised against it under the existing system of classification, the test has the potential to save thousands of lives each year.
|According to the American Lung Association, up to 87 percent of lung cancer cases are caused from smoking. |
Even if you’ve been smoking for a long time, there’s still incentive to quit: if you stop smoking, the risk of lung cancer decreases each year as normal cells replace abnormal cells.
After 10 years, the risk drops to a level that is one-third to one-half of the risk for people who continue to smoke. For more information on lung cancer, smoking and what you can do for your health, check out the National Lung Association's Web site
Their results, published in the August 10 issue of the New England Journal of Medicine, have also prompted a landmark multi-center trial that will test early-stage, non-small cell lung cancer patients.
Called the Lung Metagene Predictor, the test scans thousands of genes to identify particular patterns of gene activity in tumors that indicate a likely relapse in patients. Since recurrent tumors are often fatal, accurately classifying at-risk patients is essential.
“Using the unique genomic signatures from each tumor, our new test predicted with up to 90 percent accuracy which early-stage lung cancer patients would suffer a recurrence of their cancer and which patients would not,” said Dr. Anil Potti, assistant professor of medicine and lead study author.
In comparison, only 64 percent of patients at risk for recurring tumors were identified using more standard prognostic factors such as age, sex, tumor diameter, clinical disease stage and smoking history.
Potti added that researchers now have “a tool that can be used to move these high-risk patients from the ‘no chemotherapy’ group into the aggressive treatment group.”
Some 40,000 to 45,000 patients are diagnosed with stage one non-small cell lung cancer each year in North America. Non-small cell lung cancer is much more common than small cell, and usually spreads to other body parts. Often, such patients have their tumors removed but are not given chemotherapy because the drawbacks and side effects of the potent regimen usually outweigh the benefits – and for patients with recurrent cancer, that decision can have life-threatening consequences.
Currently, physicians assign patients to a clinical “stage” based on such criteria as tumor size, whether or not it has invaded lymph nodes and if it has spread to other organs.
“Instead of placing all patients with small tumors in the same early-stage category, as physicians currently would do, we can now assess their risk based on the tumor’s genomic profile,” said Duke’s Dr. Joseph Nevins, a molecular geneticist and senior study author. “The current system of ‘staging’ lung cancer tumors will eventually become obsolete.
Considering that even a five percent increase in patient survival could equal as many as 10,000 people a year, a new alternative for determining care couldn’t come at a better time.