Treating all cancers equally is less effective than targeting their differences, researchers are discovering.
At the University of Colorado Hospital, patient survival rates have doubled as cancer teams have learned to test for 10 subtypes of lung cancer and are finding specific treatments and new drugs for each.
“We’re learning it’s actually lots of separate diseases,” said Ross Camidge, clinical director of the hospital’s thoracic-oncology program. “When you know Mrs. Jones’ cancer is different than Mrs. Smith’s, you can give them different drugs.”
A study published Thursday in the New England Journal of Medicine details the hospital’s clinical trial results with Crozotinib, a drug available only for clinical trials.
Crozotinib has been successful in people whose tumor has a mutation in the anaplastic lymphoma kinase, or ALK gene. According to the study, six months after starting Crozotinib, the probability of being progression-free is 72 percent.
The hospital’s research can speed up the process of Federal Drug Administration approval, Camidge said.
Ellen Smith discovered last year that she was among the 5 percent of lung-cancer patients whose tumor has the ALK genetic mutation.
At stage four, her previous doctors had run out of options, but the clinical trial at University Hospital put her on Crozotinib. The twice-a-day tablet has kept her alive more than a year now and allowed her to get married in June.
“I will always have cancer,” Smith said. “It’s made it so I can live and have a really very normal life.”
State and national averages show 20 percent to 25 percent of people with stage-four lung cancer live more than a year. At University Hospital’s cancer center, the average is above 50 percent.
Steve Schneiderman had no symptoms before he landed in an emergency room in February 2009 and found out he had stage-four lung cancer.
Seeking care later at University Hospital, Schneiderman learned his tumor has a specific gene mutation — the EGFR mutant. For about a year on the drug Tarceva, his cancer has shrunk and stabilized.
“At the beginning, the news to me was . . . it’s over,” he said. “But I’m well, and I work, and I’m alive.”
Camidge said the key is the targeted match. “There’s nothing particularly wonderful about the drugs,” he said. “It’s wonderful when you give it to the right people.”
After all subtypes are classified based on gene mutations, there may be 100 lung-cancer types, he said.
University Hospital has led the way but partnered with 13 centers around the country to do the clinical trials and research that has been funded through the National Cancer Institute with federal stimulus money.
“The future in medicine is in specialized treatments,” Camidge said.
Yesenia Robles: 303-954-1372 or yrobles@denverpost.com
