Personalized Lung Cancer Targeted Therapy Obtained Support from Facts

In Sep the New England Journal of Medicine published a clinical study IPASS (Iressa Pan-Asia Study).  This study includes more than 1200 patients from mainland, Hong Kong, Taiwan of China, Japan, and Thailand.  I would like to quote the conclusion here: Gefitinib is superior to carboplatin–paclitaxel as an initial treatment for pulmonary adenocarcinoma among nonsmokers or former light smokers in East Asia.  The presence in the tumor of a mutation of the EGFR gene is a strong predictor of a better outcome with gefitinib.

This study had two important messages: (1) targeted therapy (gefitinib) is better than traditional chemotherapy (carboplatin–paclitaxel); (2) somatic mutation of EGFR predict clinical outcome.

During recent years, target cancer therapy has been criticized due to its toxicity and efficacy.  However, more and more
clinical data showed that targeted therapy had better clinical outcome than traditional chemotherapy.  This study used Tyrosine Kinase Inhibitor—Gefitinib, while we should understand TKI is the earliest type of targeted anticancer drug.  There are more types currently in clinical trial, including Hedgehog inhibitor, CDK inhibitor.

The more fascinating information from this study is that personalized medicine is not only good but necessary.  The hypothesis is quite straightforward: gefitinib target EGFR, so the lung cancer patients should have EGFR overexpression or activating mutation.  This study confirmed the hypothesis, which means (as most cancer scientists agree) lung cancer therapy should base on the genotype or genetic profiles or biomarker profile of a patient.

This study also support the other clinical trial BATTLE (Biomarker integrated Approaches of Targeted Therapy of Lung Cancer Elimination) and BATTLE 2.  I discussed this in my previous comments: http://htscorpio.spaces.live.com/blog/cns!3D9493EB6FD3999F!1529.entry