A study published online in the Journal of the American Medical Association on May 21st showed that multiple genetic tests of lung cancer tumors can help select genetic abnormalities for targeted therapy. Compared with patients who do not receive targeted therapy, patients who receive lung cancer matching therapy will have a longer survival time. However, randomized clinical trials are needed to verify whether this treatment strategy can improve patient survival.
The introduction of targeted therapy has changed the situation of lung cancer treatment by integrating tumor genotyping with treatment decisions. Adenocarcinoma is the most common type of lung cancer; 130,000 people are diagnosed with lung adenocarcinoma each year in the United States, and 1 million people are diagnosed with lung adenocarcinoma each year worldwide.
The background information of the article shows that the activity frequency of oncogene drivers of lung adenocarcinoma is expected to be 50% higher, and the molecular abnormalities of these drivers are crucial for cancer development. These drivers are defined as “active” because they can be turned negative by targeting drugs that target each abnormal site in the genome.
Dr. Mark G. Kris of the Memorial Sloan Kettering Cancer Center in New York et al. counted the frequency of carcinogenic drivers in patients with lung adenocarcinoma, and used this data to explore the proportion of patients who selected a certain targeted treatment together with overall survival . From 2009 to 2012, 14 centers in the Lung Cancer Mutation Alliance recruited patients with metastatic lung adenocarcinoma and tested tumors in patients who met specific criteria for 10 oncogene driver factors. The study was published in JAMA (2014; doi: 10.1001 / jama.2014.3741).
During the study, the researchers tested at least 1 gene on the tumors of 1007 patients, and tested 10 genes (fully genotyped patients) on the tumors of 733 patients. Of the 733 patients, 466 (64%) found an oncogene driver. 275 out of 1007 patients (28%) used these results to select a targeted therapy or enter clinical trials.
The median survival of 260 patients who carried an oncogene driver and received a targeted drug treatment was 3.5 years; the median survival of 318 patients who carried an oncogene driver but did not undergo targeted therapy was 2.4 Years; the median survival of 360 patients with no driver found was 2.1 years.
The researchers came to the conclusion that multiple genetic testing can help physicians choose a method of treating lung cancer. Although patients with a certain target drug target driver gene will prolong survival after treatment, the design of this study cannot draw decisive conclusions about the difference in survival caused by oncogene driver.
Source: Lilac Garden
