Northwestern Memorial Hospital is the only Chicago area hospital currently enrolling participants in a research study to find out if the drug Tarceva, also know as erlotinib, may help fight bronchioloalveolar cell carcinoma (BAC), a type of non-small cell lung cancer generally considered resistant to chemotherapy.
Tarceva is one of a new class of cancer drugs, know as EGFR (epidermal growth factor receptor) inhibitors, which seek to stop the spread of cancer cells by blocking the actions of the EGFR necessary for cancer cell growth. EGFR is found on the surface of many tumor cells and may be involved in the growth and virulence of those cells. Like its predecessor, Iressa, it is an example of a new generation of so-called "smart" drugs that specifically target cancer cells.
"This is an exciting study because for the first time we have a bona fide molecular target in our fight against lung cancer, in particular BAC," says lead investigator Jyoti Patel, M.D., an oncologist at Northwestern Memorial Hospital and an instructor of medicine at the Feinberg School of Medicine of Northwestern University. NMH's cancer program is affiliated with the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. "We hope Tarceva will cause the tumor to stop growing or shrink. Ultimately, we hope to manage lung cancer like a chronic disease with therapies such as this."
Patients with BAC generally live longer than those with more common non-small cell lung cancers, but BAC tumors are often multifocal and not appropriate for surgery. Many oncologists feel that BACs are less responsive to existing chemotherapeutic agents.
About 3 percent of all lung cancer patients have pure BAC tumors, and about 20 percent of all non-small cell lung cancers possess some BAC features. "BAC was once thought to be an uncommon form of lung cancer, but it appears to be increasing in incidence and more recent studies suggest that it may actually play a role in about one in five of cases of lung cancer," says Dr. Patel.
Unlike most lung cancers, BAC occurs more frequently in women than in men, and more frequently in nonsmokers than in smokers. One third of patients with BAC never smoked in comparison to about 10 percent of other lung cancers.
Previous studies have shown that about a quarter of BAC study participants respond to Tarceva after one month or more of study treatment; and the drug appears to be more effective in participants who had never smoked. Because BAC is less strongly associated with tobacco smoke than other lung cancers, these tumors may be associated with fewer molecular abnormalities and may provide a better 'target' for EGFR specific therapy.
"We'll be watching the never-smokers in our study to see if this holds up. Tobacco-related genetic changes in participants who smoke or have smoked may make them more resistant to this drug," said Dr. Patel.
Northwestern Memorial is enrolling participants with unresectable BAC who have had no or one prior chemotherapy regimen. For more information on the research study, please call Northwestern Memorial Hospital's physician referral department at 312-926-8400 or 1-877-926-4664.
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