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New clinical trials underway for advanced lung cancer patients

April 19, 2014 at 6:25 PM EDT
There was word this week of what is being described as a pioneering clinical trial being done in the U.K. for patients with advanced lung cancer. What’s so novel about this development?Hari Sreenivasan spoke to Dr. Mark Kris, an oncologist at Memorial Sloan Kettering Cancer Center, about what makes this clinical trial so interesting.
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HARI SREENIVASAN: Another medical story that caught our attention this week. Word of what’s described as a pioneering clinical trial for patients with advanced lung cancer. What’s novel is not necessarily the drugs being used, but how many and how they’re being targeted. Dr. Mark Kris, an oncologist at Memorial Sloan Kettering Cancer Center, joins us. So what are they doing in the U.K. with this clinical trial? What’s so interesting about it?

DR. MARK KRIS: They are taking a discovery that was made here almost ten years ago now where specific genes are damaged in lung tumors. And the damage brought on by those genes makes those cancer cells very susceptible to medications. So if you find one of these genetic changes and give a patient a drug targeting that, almost surely their cancer will shrink and normal tissues are not affected. I mean it’s exactly what oncologists hope to do. What they’re doing now in the U.K. is developing a nationwide program partnering with pharmaceutical companies that are developers of these drugs to do the testing in a much more generalized way and to test for many of these different gene mutations at the same time. So in essence a patient might have ten chances to find something in the tumor that’s in their body. Ten chances to get a medication. And also the pharmaceutical companies supplying drugs to go along with the discovery of those genetic markers and help individual patients.

HARI SREENIVASAN: And that’s different because we’re used to clinical trials that are one drug at a time or one gene at a time.

DR. MARK KRIS: Exactly. And also ten years ago before these mutations were discovered, everyone with a lung cancer got the same chemotherapy. Sometimes it helped, sometimes it didn’t. And we always wanted to know what is it that makes an individual’s cancer shrink or not. And this genetic information is the way we can do that, and we can really move much toward this goal of what we call personalized medicine. The right drug for the right patient.

HARI SREENIVASAN:  So if this personalized medicine trial, so to speak, happens successfully in the U.K., does that mean something like that can happen here on a larger scale in the U.S.?

DR. MARK KRIS: Well, it’s actually happening all over the world right now. And we have already completed a program here in the U.S., the Lung Cancer Mutation Consortium, where 14 hospitals did something very much like this. There are programs in France as well. It’s a whole world-wide movement. And the fact that the U.K is doing it, they’re a little sometimes slower to embrace these new technologies and new drugs. And the fact that they’re doing it says that this technology, that this idea, is becoming more and more mainstream. And it’s really going to accelerate progress.

HARI SREENIVASAN: And so tell me about how this is going to make this larger shift in terms of personalized medicine, almost on a genetic level, targeting each patient with a specific drug that could cure their cancer.

DR. MARK KRIS: So the way that it is happening now is that when the cancer is first discovered, these genetic tests are done. In the panel we have at Sloan Kettering, MSK Impact, we test for 340 different genes. And then what we try to do is find the drugs that are most likely to help a person whose cancer is driven by these genes. These genes make a cancer cell horribly dependent on the proteins that these ankA genes produce. They call it ankA gene addiction, In other words, Achilles’ heel has been the term that’s been used. So if you find that arrow to go after the Achilles’ heel, the cancer cells die. And the beautiful thing about it is these drugs are much less destructive to normal people. The other thing is if you know this person’s cancer cells don’t have this medicine, then we wouldn’t recommend that medicine to a patient. Previously, it was one size fits all. Every person with the illness got the same medicine.

HARI SREENIVASAN: Dr. Mark Kris, an oncologist at Memorial Sloan Kettering. Thanks so much.

DR. MARK KRIS: Thank you.