PRESS-NEWS.org - Press Release Distribution
PRESS RELEASES DISTRIBUTION

'Weeding the garden' lets ALK+ lung cancer patients continue crizotinib

2014-01-29
(Press-News.org) Contact information: Garth Sundem
garth.sundem@ucdenver.edu
University of Colorado Denver
'Weeding the garden' lets ALK+ lung cancer patients continue crizotinib A University of Colorado Cancer Center study published today in the International Journal of Radiation Oncology Biology and Physics shows that patients taking crizotinib for ALK+ non-small cell lung cancer may safely and durably use up to three courses of targeted radiation therapy to eradicate pockets of drug-resistant disease. Eliminating these pockets of resistant disease allows patients to continue treating the overall condition with crizotinib, leading to improved 2-year survival rates compared with patients forced to discontinue the drug sooner.

ALK+ lung cancers are caused by the aberrant reactivation of the ALK gene, and comprise about 3-5 percent of all cases of non-small cell lung cancer. In these cases, clinical studies have shown that the drug crizotinib is highly effective and the drug was rapidly approved by the FDA in 2011. Unfortunately, at around 8 – 10 months after the initiation of treatment, the cancer tends to acquire resistance to crizotinib. Earlier work at CU Cancer Center and elsewhere showed that resistance occurs through a change in the biology of the cancer. At this point, patients have generally been switched to another drug.

However, it may not be the entire cancer that develops resistance to the drug. Instead, as the change in biology is an evolutionary event only pockets of the cancer may become immune. Previous work from the CU Cancer Center described the use of a single course of radiotherapeutic local ablative therapy to eliminate these isolated pockets of resistant disease.

"The traditional paradigm for cancer patients has been to switch your systemic therapy to another agent if you progress, even though a majority of your cancer may still be controlled by the original drug. But what if we could use targeted radiation therapy to eliminate those sites of errant disease so a person could stay on a specific drug longer?" says Gregory Gan, MD, PhD, a chief resident in the University of Colorado School of Medicine Department of Radiation Oncology and the paper's first author. "Using stereotactic body radiotherapy, we can ablate these limited sites of progressive disease so patients can continue on the drug they are on – a technique we refer to as 'weeding the garden'."

The current study reports median two-year follow-up results of up to three courses of local ablative therapy to control resistant, progressive disease in ALK+ lung cancer patients.

Specifically, the group followed the experience of 38 ALK+ non-small cell lung cancer patients. Of these 38 patients, 33 progressed during the study, meaning the disease gained resistance to crizotinib. Fourteen of those patients progressed in a way that allowed for local ablative therapy. These eligible patients received 1-3 rounds of radiotherapeutic local ablative therapy to "weed the garden" of resistant pockets of disease. Examples of sites that were treated included metastases to the lung, liver, abdominal lymph nodes, and adrenal glands.

"With this long follow up, we can now see that on average it took 5.5 months from the first use of local ablative therapy until further evidence of progression on crizotinib occurred – a duration of disease control that is highly competitive with what any new drug-based therapy might be expected to achieve in the acquired resistance setting. In addition, we found that you can use radiotherapeutic local ablative therapy in the same patient multiple times with excellent control of these sites of resistant cancer and minimal to no side-effects. By keeping these patients on crizotinib for longer periods of time and/or because of the direct effect of the local ablative therapy, there was a suggestion that patients may also being enjoying a significant survival benefit," says Ross Camidge, MD, PhD, director of the Thoracic Oncology Clinical Program at the CU Cancer Center and the senior author of the study. However, Camidge cautions that this apparent overall survival benefit will need to be studied formally in a prospective clinical trial currently being established at the University of Colorado.

Among the 38 ALK+ patients, the overall survival at 2 years was 57 percent, but among those who stayed on crizotinib for more than a year it was 72 percent compared to 12 percent in those who discontinued crizotinib earlier.

"Not only does this study raise very important questions, but the pulling together of all the different analyses is part of a string of impressive achievements by Dr. Gan, who is emerging as a young leader in the field of radiation oncology," says Brian Kavanagh, MD, MPH, CU Cancer Center investigator and vice-chair of radiation oncology at the University of Colorado School of Medicine.

"We've been using radiotherapeutic local ablative therapy to control pockets of drug-resistant cancer not just in ALK+ lung cancer patients but in other types of cancer in patients on targeted therapy or chemotherapy. Radiotherapy has shown great success controlling these sites of resistant disease but more work needs to be done to fully determine when it is best to use local therapies versus a change in systemic therapy. The next step will hopefully be a prospective clinical study," says Dr. Kavanagh.

INFORMATION:

END



ELSE PRESS RELEASES FROM THIS DATE:

Research shows arsenic, mercury and selenium in Asian carp not a health concern to most

2014-01-29
Researchers at the Prairie Research Institute's Illinois Natural History Survey have found that overall, concentrations of arsenic, selenium, and mercury in bighead ...

New NASA Laser Technology Reveals How Ice Measures Up

2014-01-29
New results from NASA's MABEL campaign demonstrated that a photon-counting technique will allow researchers to track the melt or growth of Earth's frozen regions. When a high-altitude aircraft ...

Parents unclear about process for specialist care for kids

2014-01-29
ANN ARBOR, Mich. – Parents vary widely in views about their ...

Cooperative SO2 and NOx aerosol formation in haze pollution

2014-01-29
Air pollution in China has exhibited noticeable changes over the past 30 years, shifting from point-source pollution (around factories and industrial plants) in the 1980s to urban pollution in the 1990s. Since ...

Autism Speaks study finds advances towards universal early screening

2014-01-29
NEW YORK, N.Y. (January 29, 2014) – A new study from researchers at Autism Speaks, the world's leading autism science ...

Ocean acidification research should increase focus on species' ability to adapt

2014-01-28
Not enough current research on marine ecosystems focuses on species' long-term adaptation to ocean acidification creating a murky picture of our ocean's future, according ...

Research uncovers historical rise, fall and re-emergence of plague strains

2014-01-28
One branch of a deadly pathogen's family tree may have ended centuries ago, but from its ancient traces researchers can read a lineage with links to the modern world. An international ...

New studies needed to predict how marine organisms may adapt to the future's acidic oceans

2014-01-28
SAN FRANCISCO, January 27, 2014 -- The world's oceans are becoming more acidic, changing in a way that hasn't happened for millions of years. But will marine organisms ...

Brain regions thought to be uniquely human share many similarities with monkeys

2014-01-28
New research suggests a surprising degree of similarity in the organization of regions of the brain that control language and complex thought processes in humans and monkeys. The study, publishing ...

H.M.'s brain yields new evidence

2014-01-28
During his lifetime, Henry G. Molaison (H.M.) was the best-known and possibly the most-studied patient of modern neuroscience. Now, thanks to the postmortem ...

LAST 30 PRESS RELEASES:

Post-LLM era: New horizons for AI with knowledge, collaboration, and co-evolution

“Sloshing” from celestial collisions solves mystery of how galactic clusters stay hot

Children poisoned by the synthetic opioid, fentanyl, has risen in the U.S. – eight years of national data shows

USC researchers observe mice may have a form of first aid

VUMC to develop AI technology for therapeutic antibody discovery

Unlocking the hidden proteome: The role of coding circular RNA in cancer

Advancing lung cancer treatment: Understanding the differences between LUAD and LUSC

Study reveals widening heart disease disparities in the US

The role of ubiquitination in cancer stem cell regulation

New insights into LSD1: a key regulator in disease pathogenesis

Vanderbilt lung transplant establishes new record

Revolutionizing cancer treatment: targeting EZH2 for a new era of precision medicine

Metasurface technology offers a compact way to generate multiphoton entanglement

Effort seeks to increase cancer-gene testing in primary care

Acoustofluidics-based method facilitates intracellular nanoparticle delivery

Sulfur bacteria team up to break down organic substances in the seabed

Stretching spider silk makes it stronger

Earth's orbital rhythms link timing of giant eruptions and climate change

Ammonia build-up kills liver cells but can be prevented using existing drug

New technical guidelines pave the way for widespread adoption of methane-reducing feed additives in dairy and livestock

Eradivir announces Phase 2 human challenge study of EV25 in healthy adults infected with influenza

New study finds that tooth size in Otaria byronia reflects historical shifts in population abundance

nTIDE March 2025 Jobs Report: Employment rate for people with disabilities holds steady at new plateau, despite February dip

Breakthrough cardiac regeneration research offers hope for the treatment of ischemic heart failure

Fluoride in drinking water is associated with impaired childhood cognition

New composite structure boosts polypropylene’s low-temperature toughness

While most Americans strongly support civics education in schools, partisan divide on DEI policies and free speech on college campuses remains

Revolutionizing surface science: Visualization of local dielectric properties of surfaces

LearningEMS: A new framework for electric vehicle energy management

Nearly half of popular tropical plant group related to birds-of-paradise and bananas are threatened with extinction

[Press-News.org] 'Weeding the garden' lets ALK+ lung cancer patients continue crizotinib