Chemotherapy Resistance Testing in Lung Cancer Patients Needs to Be Studied
A study led by a lung cancer surgeon at Jefferson Medical College suggests that oncologists should take more advantage of laboratory tests that have the potential to help determine a lung cancer patient's resistance to chemotherapy drugs. All too often, patients with non-small-cell lung cancer (NSCLC) are given standard chemotherapy drugs after surgery in a "hit or miss" fashion, without doctors knowing which drugs might have better chances than others to help treat the tumor. Steps should be taken to validate such resistance tests in clinical trials.
Reporting recently in the Journal of Thoracic and Cardiovascular Surgery, Thomas d'Amato, M.D., Ph.D., assistant professor of surgery at Jefferson Medical College of Thomas Jefferson University in Philadelphia, and his colleagues analyzed data on 4,571 non-small cell lung cancer tumors' resistance to four pairs of chemotherapy agents, each of which included a standard platinum-based drug: carboplatin and paclitaxel (taxol), cisplatin and navelbine, cisplatin and docetaxel and cisplatin and gemcitabine.
Using the "extreme drug resistance" test to monitor cancer resistance in a test tube, they found resistance in 30 percent of tumors to carboplatin-paclitaxel, 24 percent to cisplatin-navelbine, 42 percent to cisplatin-gemcitabine and 27 percent to cisplatin-docetaxel.
"Clinical unresponsiveness for most patients with lung cancer to standard chemotherapy may be explained and measured accurately with an assay that measures a specific patient's tumor resistance to a given cytotoxic drug," Dr. d'Amato says. "This assay has the potential to guide therapy and can be used to tailor a patient