A Tale of Two Lung Cancers
November 10, 2010 Leave a comment
I was recently asked to speak at a community outreach mixer to describe our work in lung cancer. I invited two patients to join me:
- A woman in her early 50s who presented to medical attention with metastatic adenocarcinoma of the lung with brain involvement.
- A woman in her early 60s, also with metastatic adenocarcinoma with brain involvement.
Under the microscope their tumors appeared almost identical. But, in the laboratory, the profiles were distinctly different. Patient no. 1 revealed a highly sensitive profile to the EGFR-TKI erlotinib (Tarceva) that was demonstrably enhanced by VEGF inhibition (e.g. Bevacizumab, Avastin). The second patient was resistant to erlotinib and VEGF inhibition, but was highly sensitive to the doublet of platinum plus gemcitabine.
Both patients attended the mixer and spoke to the crowd. They both looked the picture of health, sporting their own hair with no significant toxicities from therapy. Both had completed Cyberknife brain radiation and had gone on to exactly the right treatment for them. Despite their similarities in presentation and histology, their treatments were extremely different. Yet, both have had excellent and durable responses.
Every lung cancer patient has the capacity to do well. It is our job to find out which drugs and combinations are most likely to achieve that end. Functional profiling provided both of these patients exactly the right treatment for them. With the Rational Therapeutics EVA-PCD platform, every patient is treated as an individual.