Which Lung Cancer Patients Need Chemotherapy to Live
Early Stage Lung Cancer and Chemotherapy
Duke University Medical Center scientists have developed the first-ever genomic test to predict which patients with early-stage lung cancer will need chemotherapy to live and which patients can avoid the toxic regimen of drugs.
The test has the potential to save thousands of lives each year by recommending chemotherapy for patients who are currently advised against it, said the test's developers at Duke's Institute for Genome Sciences & Policy.
The test's promising results have initiated a landmark multi-center clinical trial, to be led by Duke investigators next year. Patients with early-stage non-small cell lung cancer, the most common and fatal form of cancer, will receive the genomic test and its results will determine their treatment.
The new test, called the Lung Metagene Predictor, scans thousands of genes to identify patterns of gene activity in individual tumors that indicate a patient is likely to suffer a recurrence of disease. Recurrent tumors are typically fatal, so identifying at-risk patients is critical to properly treating them, said the Duke researchers.
"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 Anil Potti, M.D., an assistant professor of medicine and lead author of the study. "We now have a tool that can be used to move these high-risk patients from the 'no chemotherapy' group into the aggressive treatment group."
The researchers will publish their findings in the Aug. 10, 2006, issue of the New England Journal of Medicine. The research was funded by the National Institutes of Health.
The genomic test can theoretically apply to any cancer, but the Duke team focused its effort on lung cancer because the survival rate is just 15 percent. Lung cancer now kills more Americans each year than breast, prostate and colorectal cancers combined. But toxic chemotherapy drugs are prescribed only to patients with relatively large and aggressive tumors.