The Clinical Applications of Functional Profiling CSRA: Lung Cancer

Lung cancer, with 215,000 new diagnoses and 162,000 deaths in the United States each year, represents the leading cause in cancer death in the US. Average response rates of 30 percent and median survivals of 12 months remain static over decades. The five-year survival of 15 percent for this disease has not changed in 50 years.

While better surgical techniques and the introduction of new drugs have improved the one-year survival from 35 percent to 41 percent in the last 20 years, this has not had a major impact on overall survival.

Few diseases offer the opportunity to meaningfully improve cancer survival like lung cancer. A 25 percent improvement in survival in lung cancer would be the numerical equivalent of curing breast cancers outright. Recognizing this opportunity, we have made lung cancer a principal focus of the functional profiling platform. Our current IRB approved clinical protocol in non-small cell lung cancer applies our functional profiling platform to select from among the commercially available FDA approved compendium listed drugs, in metastatic non-small cell lung cancer. The results of our study have been submitted to national meetings. To date, our approach has more than doubled the objective response rate to 69 percent, improved the time to progression, provided over one-third of our stage IV patients the capacity to undergo definitive radiation or surgery, and extended the lives of some stage IV patients to five or more years. By exploring the first line use of the newer targeted agents, many patients are achieving durable responses without ever being exposed to classic chemotherapeutic drugs. It is our intent to make these laboratory analyses available to all newly diagnosed and relapsed lung cancer patients.

About Dr. Robert A. Nagourney
Dr. Nagourney received his undergraduate degree in chemistry from Boston University and his doctor of medicine at McGill University in Montreal, where he was a University Scholar. After a residency in internal medicine at the University of California, Irvine, he went on to complete fellowship training in medical oncology at Georgetown University, as well as in hematology at the Scripps Institute in La Jolla. During his fellowship at Georgetown University, Dr. Nagourney confronted aggressive malignancies for which the standard therapies remained mostly ineffective. No matter what he did, all of his patients died. While he found this “standard of care” to be unacceptable, it inspired him to return to the laboratory where he eventually developed “personalized cancer therapy.” In 1986, Dr. Nagourney, along with colleague Larry Weisenthal, MD, PhD, received a Phase I grant from a federally funded program and launched Oncotech, Inc. They began conducting experiments to prove that human tumors resistant to chemotherapeutics could be re-sensitized by pre-incubation with calcium channel blockers, glutathione depletors and protein kinase C inhibitors. The original research was a success. Oncotech grew with financial backing from investors who ultimately changed the direction of the company’s research. The changes proved untenable to Dr. Nagourney and in 1991, he left the company he co-founded. He then returned to the laboratory, and developed the Ex-vivo Analysis - Programmed Cell Death ® (EVA-PCD) test to identify the treatments that would induce programmed cell death, or “apoptosis.” He soon took a position as Director of Experimental Therapeutics at the Cancer Institute of Long Beach Memorial Medical Center. His primary research project during this time was chronic lymphocytic leukemia. He remained in this position until the basic research program funding was cut, at which time he founded Rational Therapeutics in 1995. It is here where the EVA-PCD test is used to identity the drug, combinations of drugs or targeted therapies that will kill a patient's tumor - thus providing patients with truly personalized cancer treatment plans. With the desire to change how cancer care is delivered, he became Medical Director of the Todd Cancer Institute at Long Beach Memorial in 2003. In 2008, he returned to Rational Therapeutics full time to rededicate his time and expertise to expand the research opportunities available through the laboratory. He is a frequently invited lecturer for numerous professional organizations and universities, and has served as a reviewer and on the editorial boards of several journals including Clinical Cancer Research, British Journal of Cancer, Gynecologic Oncology, Cancer Research and the Journal of Medicinal Food.

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