Upcoming Lung Cancer Drugs

Non small cell lung cancer treatment trial successes with xalkori and BMS-936558

(RxWiki News) Out of the top five most common cancers, lung cancer is projected to remain the deadliest, and it isn't just limited to people who smoke.

New therapies presented at the annual meeting of the American Society of Clinical Oncology showcase the two newest lung cancer treatments for non small cell lung cancers.

One presentation expands the use of an existing FDA-approved drug, while the other discussed further testing of an entirely new treatment.

"Ask your oncologist about clinical trials available to you."

Alice Tsang Shaw, MD/PhD, from Massachusetts General Hospital's Cancer Center, presented the updated results in a trial using Xalkori (crizotinib) in the first specific testing of Xalkori for non small cell lung cancers where the gene ROS1 was the target. Xalkori was developed for non small cell lung cancers that have a mutation in the ALK gene.

Clinical testing in the past showed that Xalkori's use in lung cancer patients with the ALK mutation might overlap the ROS1 pathway, and the evidence seems to support this theory.

In initial testing, 8 of the 14 patients in the trial successfully responded to the Xalkori treatment. One of the original 15 patients was dropped from the study, researchers cited continuous disease progression as the reason.

Further plans for extensive clinical testing of Xalkori in non small cell lung cancer patients with ROS1 mutations were announced.

In the second presentation on non small cell lung cancer treatments, researchers discussed their newly developed targeted molecular therapy.

The experimental antibody (BMS-936558) was evaluated for use in advanced non small cell lung cancers, enrolling patients that had not had any success with previous therapies.

In the first phase of clinical testing, few definite conclusions about the treatment other than lack of acute toxicity can be drawn, but researchers were encouraged by a decrease in overall tumor burden both clinically and in laboratory examination of tumor samples after a daily dosing of BMS-936558 for ten weeks.

The study first looked at overall safety profile in 122 patients, following up with a second study of 76 patients that focused on the treatment's effect on cancer progression.

Most patients had a predictable side effect profile of fatigue, rash, diarrhea and itching, but severe lung inflammation leading to death occurred in three of the cancer patients.

First author of the study, Julie Brahmer, MD, concluded that the antibody showed enough promise for her team to continue the clinical trial.

The next phase of testing will also include patients who have shown no response to previous treatments such as platinum based chemotherapies or tyrosine kinase inhibitors. Researchers concluded that the drug trials showed a clear benefit to the patients' quality of life.

Initial conclusions from the trial showed that 18 percent of patients treated with the BMS-936558 antibody had a measurable improvement in their symptoms, and 26 percent still had no signs of cancer progression when evaluated at the 24 week mark.

Giuseppe Giaccone of the National Cancer Institute, MD/PhD, mentioned during the conference that BMS-936588 had fewer severe side effects than ipilimumab, a similar antibody currently undergoing testing for use in non small cell lung cancer.

Although he stated that the deaths from lung inflammation needed to be investigated further, Dr. Giaccone felt that there was clear potential for the drug's future trials, partly due to evidence of effectiveness in some types of lung cancer that do not have effective treatments available at the present time.

Research data presented at conferences is considered preliminary until publication in a peer-reviewed journal.

Financial relationships disclosed by research teams in this article included ties to ARIAD, Chugai Pharma, Daiichi Sankyo, Pfizer, Millennium, Novartis, AstraZeneca, Agios, Biogen Idec, Boehringer Ingelheim, Bristol-Myers Squibb, Celgene, Endo Pharmaceuticals, GATEKEEPER Pharmaceuticals, Genentech, GlaxoSmithKline, Quintiles, Sanofi, Abbott Laboratories & Abbott Molecular, Intellikine, Merck, Merrimack, Amgen, Clovis Oncology, and OSI/Astellas.

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Review Date: 
June 7, 2012