An international study involving Manchester researchers has found that for previously untreated lung cancer patients with a particular genetic change, a new targeted therapy is better than standard chemotherapy.
Some patients with non-small cell lung cancer (NSCLC) have changes in the anaplastic lymphoma kinase (ALK) gene, which can drive the development of their cancer. A drug recently developed by Pfizer, crizotinib, targets ALK and is currently given to patients with ALK positive lung cancer when their cancer has worsened after initial chemotherapy. Now doctors have investigated the use of crizotinib in patients with ALK positive lung cancer who have not yet received any chemotherapy treatment.
Dr Fiona Blackhall, a senior lecturer in The University of Manchester’s Institute of Cancer Sciences and a consultant based at The Christie NHS Foundation Trust — both part of the Manchester Cancer Research Centre — said: “In order to introduce precision medicine, where each cancer patient receives treatment designed to target the genetic makeup of their individual cancer, we need to compare how effective the new targeted treatment is compared to standard chemotherapy treatment.”
The latest study, published in the New England Journal of Medicine, involved 343 patients with previously untreated ALK-positive advanced NSCLC. It showed that those patients who received crizotinib did better with respect to improvement in symptoms and delay in growth of the cancer than those on standard chemotherapy. Also the new targeted drug had no unexpected side effects.
The research team are now waiting for more mature data from the study to see whether crizotinib also improves overall survival in this patient group.
“There is growing evidence that such targeted therapies can offer greater hope to lung cancer patients. Around 1,600 people are diagnosed with non-small cell lung cancer in Greater Manchester every year and a proportion of these patients will have the ALK-positive type. Our study findings could change the way we treat these patients,” added Dr Blackhall.
- Benjamin J. Solomon, Tony Mok, Dong-Wan Kim, Yi-Long Wu, Kazuhiko Nakagawa, Tarek Mekhail, Enriqueta Felip, Federico Cappuzzo, Jolanda Paolini, Tiziana Usari, Shrividya Iyer, Arlene Reisman, Keith D. Wilner, Jennifer Tursi, Fiona Blackhall. First-Line Crizotinib versus Chemotherapy inALK-Positive Lung Cancer. New England Journal of Medicine, 2014; 371 (23): 2167 DOI: 10.1056/NEJMoa1408440