Lung Cancer Response Rates Double – ASCO Presentation

On Sunday, June 6, 2010, I presented “Phase II Trial of Personalized Chemotherapy In Stage IV NSCLC: Clinical Application of Functional Profiling in First-Line Therapy” (Abstract No. 7617; Citation: J. Clin Oncol 28:7s, 2010) at the 2010 ASCO Annual Meeting. Colleagues received the presentation very well, with hundreds of attendees examining the findings.

The data are very exciting. This trial of 29 patients with metastatic (Stage IV) NSCLC achieved a response that was twofold higher than the national average (62 vs. 31 percent: p=0.0003). More striking was the 50 percent improvement of median time to progression (9.5 months vs. 6 months). And most exciting of all, the very excellent survival data with a median overall survival of 22.3 months compared with the national average of 12 months.

The most interesting aspect of this study is the fact that we utilized the very same chemotherapy drugs that are available to all medical oncologists in the United States. The trial was limited to FDA approved, compendium listed agents with specific indications for NSCLC. As such, we did not apply new classes of drugs, yet doubled the response rate and median overall survival.

The implications of this are staggering, particularly when we consider the impact that targeted agents are having on cancer care. I will explore these implications in the next entry when I discuss such agents.

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.

3 Responses to Lung Cancer Response Rates Double – ASCO Presentation

  1. Pingback: Poster from Rational Therapeutics Lung Cancer ASCO Presentation « Dr. Robert A. Nagourney's Blog

  2. Amy says:

    Is this an option for squamous non-small cell?

    • Yes.

      Squamous cell is one of the varieties of non small cell lung cancer (NSCLC). In the past all of the non small cells were lumped together. Today, we realize that different types of lung cancer have different biology and that this is can have an impact on outcome. Nonetheless, most of the treatments for NSCLC are used in both squamous cell and non-squamous cell types. Recent literature has found that Gemcitabine combinations may be less effective in the squamous cell types, but even this is not absolute. Squamous cell lung cancer can certainly be helped with effective chemotherapy.

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