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Lung Cancer News
Sep. 21, 2023 — Small cell lung cancer accounts for about 15 percent of all diagnosed lung cancers and is still associated with a high mortality rate. SCLC tumours often develop resistance to chemotherapy and thus ...
Sep. 12, 2023 — An international team of researchers has demonstrated that a combination of inhibitors may suppress tumor growth and prevent relapse in patients with certain cancers, including head and neck squamous ...
Sep. 4, 2023 — Scientists have discovered two new genes that cause head and neck cancer patients to be resistant to chemotherapy, and that silencing either gene can make cancer cells previously unresponsive to ...
Aug. 31, 2023 — Vitamin C and other antioxidants stimulate the formation of new blood vessels in lung cancer tumors, a new study shows. The discovery corroborates the idea that dietary supplements containing ...
Aug. 30, 2023 — Fresh discoveries about a type of immune cells could give lung cancer patients a more accurate prognosis and better identify who will benefit from immunotherapies. Researchers found that the location ...
Aug. 14, 2023 — Patients with localized prostate cancer have a good chance of survival, but mortality rates among those with advanced, metastatic forms of the condition remain high. Until now, the precise mechanism ...
Aug. 9, 2023 — New findings may lead to relapse-free treatment for a sizeable subgroup of lung cancer patients. In a study in mice, scientists have identified a biomarker that may help physicians select lung cancer ...
July 12, 2023 — Cancer therapies that target specific genetic abnormalities in tumors have revolutionized treatment possibilities over the past two decades. While quality of life and survival are improved with ...
July 12, 2023 — Prostate cancer is a leading cause of death among American men, and it's resistant to one of the most powerful chemotherapy medications -- cisplatin. Now, researchers have developed the first ...
June 22, 2023 — Small-cell lung cancer is a particularly aggressive type of tumor with a consistently high mortality rate. In recent years, the research of scientists has significantly contributed to a better ...
Mar. 28, 2023 — Researchers develop a 3D cell culture system to test how inhibiting fibroblast activities can help treat lung cancer. To simulate the tumor microenvironment and mimic real tissues, the team ...
Mar. 17, 2023 — A new study has revealed FDA-approved trametinib and entinostat (which is currently in clinical trials) can be given in tandem to produce fewer and smaller tumors in mice with LKB1-mutated non-small ...
Mar. 15, 2023 — A new study represents a first step towards generating highly detailed 3-dimensional maps of lung tumors using genetically engineered mouse ...
Mar. 13, 2023 — Scientists have discovered why breast cancer cells that have spread to the lungs may 'wake up' following years of sleep -- forming incurable secondary tumors. Their research reveals the ...
Feb. 13, 2023 — Researchers show how stimulating dendritic cells through certain pathways produces strong T cell activity against tumors and works in conjunction with immune checkpoint inhibitors to produce even ...
Feb. 1, 2023 — New data from a clinical trial shows improved rates of survival and reduced risk of recurrence in patients taking osimertinib, a targeted therapy for non-small cell lung cancer ...
Jan. 9, 2023 — A new study found that deleting a gene called KMT2D caused normal (basal) lung cells grown in complex cultures called organoids to transform into lung squamous carcinoma (LUSC) ...
Jan. 4, 2023 — A research team has shown that Sarunashi juice and its constituting component isoquercetin help prevent and reduce lung cancer in laboratory ...
Dec. 26, 2022 — Researchers report that they have developed a new experimental pipeline to combine bacterial therapy with current cancer drugs. Their study, which explores resistance to bacterial therapy at the ...
Dec. 1, 2022 — About 80% of people with cancer suffer from significant muscle wasting, or loss of muscle tissue, and 30% of these patients die from this condition. New research in mice finds that the severity of ...
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UMich Researchers Use Chip That Can Assess If Lung Cancer Treatment Is Working
A University of Michigan study published in February used an electronic chip to detect the quantity of circulating tumor cells, or cells shed from a tumor that enter the bloodstream, in non-small cell lung cancer patients. The goal of the study was to use the chip technology to track the progress of cancer treatments such as chemotherapy and radiation therapy.
Non-small cell lung cancer is the most common type of lung cancer in the United States and accounts for 81% of lung cancer diagnoses nationally. There are four stages of cancer progression and a cancer reaches stage four when the tumor metastasizes, or spreads as CTCs break off from the original tumor and enter the bloodstream to travel to distant parts of the body.
Researchers used the graphene oxide microfluidic chip to process blood samples taken from 26 patients at six different time points throughout their treatment for stage three non-small cell lung cancer. Sunitha Nagrath, chemical engineering professor and co-corresponding author of the study, said she and her team developed the chip in 2013, which uses antibodies to target and trap CTCs against graphene oxide sheets as the blood sample runs through it.
In an interview with The Michigan Daily, Nagrath said it is difficult to find CTCs in the earlier stages of cancer, so they wanted to develop a device capable of successfully trapping them.
"At the earliest stages, the challenge is the (circulating tumor) cells are much rarer," Nagrath said. "To have the ability to isolate these few cells, we knew we needed a very sensitive technology. … So, we created these islands of graphene oxide nanosheets. It's like having these 'nano arms' that can grab onto the cells much more efficiently."
The study aimed to use information from the chip to individualize treatment plans for lung cancer patients during a six-week course of weekly chemotherapy and radiation treatments. Shruti Jolly, Medical School professor of radiation oncology and co-corresponding author of the study, told The Daily the team chose to take blood samples four weeks into treatment.
"Instead of giving everybody the same treatment, we were trying to figure out are there some patients that need more dose, are there some who could get away with less dose," Jolly said. "We picked the four-week mark because it's enough time so we detect (if the treatment) started working or not, but we still had those two weeks left. So if we needed to alter something, we still had the ability to change our course."
Jolly said the chip could offer a less invasive approach than current methods used to track the effectiveness of lung cancer treatments, such as physical biopsies.
"The advantage of technology like CTCs is you could just get a blood sample, and then be able to detect them," Jolly said. "You can't geographically know where they are coming from. … That's why we don't necessarily diagnose lung cancer with it, but it's a great way to be able to detect whether the treatments we're giving lifts the burden of the circulating tumor cells."
Currently, physicians also often use CAT scans to see if a tumor shrank and thus determine treatment effectiveness. However, cancers can take weeks or months to respond to treatment and shrink. Jolly said the chip method could help physicians assess whether a treatment is working earlier on.
"The reason (physicians) have to wait for the three-month time period is because we actually need the tumor to shrink," Jolly said. "In order for us to see that radiographically, it takes many weeks, versus the decrease in (circulating tumor) cells, you can detect (that) much quicker."
In an interview with The Daily, Engineering sophomore Ian Paclik said he is interested in biomedical research and found the study to be promising in the field of cancer research.
"If they can get down the issue of sensitivity, getting a live update or profile of cancer while it's developing would be very useful," Paclik said. "Cancer is unique to each person. … Personalizing a treatment plan for each patient, as the study is trying to do, is very important and very widely applicable."
Although further studies are needed to corroborate the results of the study, Nagrath said she is excited about the results and hopes the chip can be used in clinical settings to help non-small cell lung cancer patients.
"It's very exciting to see the agility of the tools that we develop in the lab and be used in the clinic," Nagrath said. "Maybe we could find partners who would be interested in developing (the chip) into a commercially available tool. … Then this technology could be much more widely available beyond (the) University."
Daily Staff Reporter Eilene Koo can be reached at ekoo@umich.Edu.
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ALK-Positive Lung Cancer In Focus
What advancements for ALK-positive non-small cell lung cancer are on the way, from treating earlier stages of disease to postsurgical options?
When Daniel Wilson, a then-34-year-old father and husband in Chalfont, Pennsylvania, went to the emergency room for what he calls "a cold that didn't go away" that caused coughing 200 to 300 times a day, "the last thing" his doctors expected to find was lung cancer, he says.
Not only did Wilson receive a diagnosis of stage 4 non-small cell lung cancer (NSCLC) in February 2019, but the news was delivered with what he and his wife found to be a surprising degree of optimism.
Daniel Wilson's treatment for ALK-positive NSCLC has resulted in side effects including sensitivity to sunlight, he says.
Photo credit: Robert Barilla
"They shared that it was ALK-positive lung cancer. That didn't mean anything to my wife and I, but they went on to say it was like hitting the lottery," Wilson says. "How do you receive a stage 4 cancer diagnosis, lung cancer specifically, without having a past of any environmental factors that would lead to it? And be told, 'Yeah, you hit the lottery.' What we didn't understand was that [the diagnosis] gave us opportunities to [try] some targeted therapies to extend my life as opposed to just straight immunotherapy and chemotherapy."
Wilson is taking Alecensa (alectinib), an oral medication known as an anaplastic lymphoma kinase (ALK) inhibitor, which inhibits the growth of tumor cells that overexpress ALK, a protein that controls cell growth, as explained by the National Cancer Institute. Alecensa is among the drugs focused on ALK that continue to make waves in the oncology world nearly a decade after its introduction, as targeted therapies become available for patients at earlier disease stages and advancements are made for patients whose tumors can be surgically removed.
'It's Made All the Difference'Alecensa initially received accelerated approval from the Food and Drug Administration (FDA) for patients with ALK-positive NSCLC that had metastasized (spread from the lungs to other parts of the body) and who had progressed on Xalkori (crizotinib; the first approved ALK-targeting treatment) in 2015, then as a frontline treatment in 2017.
"ALK ... Is a gene that's expressed during fetal development, and then your body turns it off," explains Dr. Ken Culver, director of research and clinical affairs for the organization ALK Positive. "But for reasons we don't understand, this gene gets reactivated in some people. That reactivation leads to the cells growing faster than they should. And that manifests itself in cancer, [including] lung cancer."
"When we talk about ALK-positive lung cancer, we're really describing [NSCLC], which is the most common type of lung cancer, harboring a specific genetic change. We don't mean genetic in the sense of something that's inherited. We mean genetic in the sense that it's the result of changes in our genetic material or DNA," explains Dr. Stephen Liu, a medical oncologist who leads the Thoracic Oncology and the Developmental Therapeutics sections at Georgetown University's Lombardi Comprehensive Cancer Center in Washington, D.C.
"The specific change here is a chromosomal rearrangement or a gene fusion. ... We know that within [types of ] adenocarcinoma of the lung, there are a lot of different cancers, and if we look at the DNA level, we can see significant changes," Liu says. "These changes define different subsets of cancer, they define the biology, they dictate how those cancers behave, and now we finally have the ability to leverage those changes in treatments. We use those specific genetic changes to help guide which treatments to give and which not to give. The general model for that is precision oncology, precision therapy and biomarker-driven treatment for lung cancer, and it's made all the difference."
Postsurgical Treatment AdvancementsLiu highlights the phase 3 ALINA trial, which showed that among patients with stage 1B to 3A ALK-positive NSCLC, treatment with Alecensa resulted in a 76% reduction in the risk of death or disease recurrence when compared with treatment via platinum-based chemotherapy.
Based on the ALINA findings, the FDA accepted a supplemental new drug application and granted priority review to Alecensa as an adjuvant (postsurgical) treatment for patients with early-stage ALK-positive NSCLC.
A retrospective study published in Scientific Reports found that Xalkori-based adjuvant therapy also improved the outcomes of patients with ALK-positive lung cancer, with researchers writing that the study "confirmed the effective and feasible therapeutic approach of postoperative targeted therapy in ALK-positive lung cancer."
"We don't necessarily think we cure people with the targeted therapies," says Dr. Heather Wakelee, Winston Chen and Phyllis Huang Professor and Chief of the Division of Oncology at Stanford University in California. "We substantially delay time before cancer comes back with these treatments, if it's going to come back, and that is a really meaningful outcome, because living without known active cancer [and having to take] a medication every day is different, and most would say much better, than that feeling of waiting for when [the disease is] going to come back or living with known active cancer and then taking the medication [after the fact]."
Other noteworthy trials, Wakelee says, include the phase 3 ALCHEMIST trial evaluating Xalkori for patients with stages 1B to 3A ALK-positive NSCLC that has been surgically removed and the phase 3 CROWN study in metastatic disease that showed the ALK inhibitor Lorbrena (lorlatinib) conferred a "durable benefit ... Over [Xalkori] in patients with treatment-naive, ALK-positive [NSCLC]," according to findings published in The Lancet Respiratory Medicine. Lorbrena received accelerated FDA approval in 2018 for second- or third-line treatment of ALK-positive metastatic NSCLC.
Addressing Unmet NeedsThere are between 90 and 100 current clinical trials in the United States and the European Union allowing patients with ALK-positive NSCLC, Culver says, with 15 or so being for treatments specifically designed to target ALK-positive disease.
ALK fusions exist in 3% to 5% of patients with NSCLC, Liu says. Their presence is not associated with a history of smoking, and ALK-positive cancers have a high likelihood of spreading to the brain.
"Typically, patients tend to be younger, but we see this in every demographic: young, old, male, female, and [it's] something we see all over the world," Liu says. "Importantly, you cannot tell if someone has or does not have an ALK fusion just by looking at them, just by talking to them. The only way to know for sure is to test [the tumor] for the fusion. And because this is such an important alteration, and one we cannot afford to miss, everyone with lung cancer should be tested for the presence or absence of ALK fusion."
There are approximately 10,000 new cases of ALK-positive lung cancer each year, with an average survival of seven years and approximately 70,000 patients with ALK-positive lung cancer currently living in the United States, Culver says.
Treatment with the next-generation inhibitor, iruplinalkib, reduced the risk of disease progression or death by 66% when compared with Xalkori, which was originally approved by the FDA in 2011 for patients with metastatic or locally advanced (meaning it spread to nearby tissue or lymph nodes) ALK-positive NSCLC, as a first-line treatment among this patient population, according to findings from the phase 3 INSPIRE trial published in the Journal of Thoracic Oncology.
Looking forward, Liu says therapies can become even more specific, targeting ALK-positive subtypes.
"Finding those differences and leveraging the advantage is really key to the future," Liu says.
Among the promising new treatments, Liu says, is the novel drug NVL-655, which, in the recent phase 1/2 ALKOVE-1 trial, was found to elicit an objective response rate (patients whose disease responded partially or completely to treatment) of 39%, with treatment-related side effects leading to discontinuation or a dose reduction in 2% and 5% of patients, respectively.
'I Did Have a Little Cough'For Brandi Bryant, whose cancer journey began with shortness of breath, her condition had to drastically worsen before she was given access to targeted therapy.
A mother of four in Decatur, Georgia, Bryant was 39 in November 2017 when she began experiencing shortness of breath while talking on the phone. Bryant, who says her regular exercise regimen used to include walking several miles a day, notes that she had also been dealing with a tiny, yet persistent, cough.
Brandi Bryant, who received an initial diagnosis of stage 3B ALK-positive NSCLC in January 2018, has been taking Alecensa for nearly six years.
Photo provided by Bryant
"It wasn't annoying," Bryant says. "It wasn't anything that kept me up [at night]. My ex-husband, at the time [he] told me that, 'Sometimes you cough at night,' but it didn't interrupt my sleep, so it was never anything that [concerned me]."
Bryant received an initial diagnosis of stage 3B ALK-positive NSCLC in January 2018 and was told she would be started on a treatment plan of six rounds of chemotherapy and 30 rounds of radiation.
"Once my doctor told me that my biomarker test results were in, this was like three weeks after they had been sent out [and] three to four weeks before I started my chemo, I asked her, 'Why can't I do this [targeted therapy]?' And she said, 'We're going with the standard of care, and with curative intent," opting for a chemoradiation regimen, she says.
Bryant connected with ALK Positive and researched her disease.
"I was just thinking about the people who I saw, who I knew were on a targeted therapy of some sort, versus the people who I saw in my infusion room when I was getting chemo, and I really just wanted to be able to take that. I knew that it would be an easier route for me," Bryant said.
After completing four rounds of chemotherapy and approximately 20 rounds of radiation, Bryant was hospitalized for a fever and had trouble breathing and performing actions such as going up and down stairs. Doctors, she says, drained fluid from around her heart that they discovered was "full of malignant cells," and determined that her cancer had metastasized, reaching stage 4.
"After I was released from the hospital, I had a meeting with my oncologist and she told me, 'Well, now you're eligible for targeted therapy,'" Bryant says.
Bryant started treatment with Alecensa in May 2018, and her condition quickly improved. "Honestly, within just a couple of weeks, other than the side effects for [Alecensa] like a sluggish feeling, heavy legs and being fatigued, I didn't have that many issues," she says. "And within two to three weeks, I was able to easily climb the stairs again. [I thought,] 'Oh my gosh, I know this is working.'"
'A Very Significant Health Problem'Wilson, who was treated with radiation shortly after his diagnosis, began taking Alecensa in March 2019. "That's been my first-line therapy since I was diagnosed," he says. "I have had some additional radiation done to my chest, where it wasn't targeted previously, just to clean up some residual cells, and I've been stable [in] scans since 2021."
Wilson experienced digestive issues, which required attention to his diet, and sunlight sensitivity.
"Anybody who does know me is used to seeing me in long sleeves at any point of the year, and also seeing me in a hat, most likely a bucket hat, just to protect myself because even 10 minutes of direct sunlight [causes] burning on the hands. It feels like a chemical burn. So, it can be kind of tough, having kids and being active coaching both of their soccer teams, and being outdoors, trying to balance being that active dad, being present, and hiding from the sun at the same time."
"Think about diabetes," Wakelee says. "We don't cure diabetes; people live their life chronically on medications. That's OK. That's still a win. I think that we would love to be able to think about cancer as 'It's gone, gone, gone,' [but] if people end up living out the life that they would have lived otherwise, having to take medication with minimal side effects, it's not quite as good as cancer being gone, gone, gone. But it's certainly much better than living with symptoms from your cancer."
Nearly six years after starting treatment, Bryant is still taking Alecensa.
"I thought I was going to be dead in six years," she says. "And I'm clearly not going to die anytime soon, unless an Acme anvil hits me. That's the only thing that's going to take me out right now. So, I've got some time."
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