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Rose day: A Day of hope for cancer patients. A cancer researcher considers the progression of lung cancer treatments.
27 Jan' 21

Rose day: A Day of hope for cancer patients. A cancer researcher considers the progression of lung cancer treatments.

 


Scientific breakthroughs and novel treatments have improved results drastically in the previous two decades, extending the life expectancy of some patients significantly.  

 

Lung cancer treatment is being revolutionized by precision medicine.  

This transformation is emblematic of a larger trend in health care today: the rise of precision medicine. In the past, most medical therapies were created with the typical patient in mind. Because everyone is unique, this one-size-fits-all approach has resulted in treatments that are effective for some patients but not for others. 

However, as researchers have discovered the genetic alterations that cause healthy cells to become malignant, tailored medicines — smart bombs aimed exactly at chemicals prevalent in cancer cells but not in healthy cells — have become possible.  

 

Why is EGFR important in the treatment of lung cancer?  

EGFR is a protein found in epithelial tissue, which includes the outer layer of skin as well as the lining of internal organs and cavities, such as the lungs and the gut.  

 EGFR acts as a switch in healthy tissue, directing the cell to divide and expand appropriately in response to changes in its environment. A mutation in the gene that makes the EGFR protein, on the other hand, can result in uncontrolled cell growth. 

Five FDA-approved medicines targeting the renegade EGFR protein have been developed for the treatment of lung cancer. Gefitinib (Iressa), erlotinib (Tarceva), and afatinib are examples of EGFR inhibitors (Gilotrif).  

Fortunately, the vast majority of patients who are treated with EGFR inhibitors have a good response, with their malignancies being held at bay for up to two years. Other treatments may then be used to help some individuals live longer. 

 

Promise vs. reality of targeted therapy  

Targeted therapy, while its promise, is not without flaws. For starters, EGFR inhibitors only benefit cancer patients who have the EGFR mutation, and they don't help cancer patients who don't. Second, while some people see their cancer almost totally disappear, for others, the treatment just slows tumor growth. Perhaps most disappointing, even in patients who respond well to treatment,  the medication ceases working after a year or two as tumor cells' resistance to the treatments increase. The approach of taking many tissue samples of tumors during a patient's treatment was used to try to unravel this puzzle. 

Changes in treatment have resulted from the realization that not all cancer cells are alike, even within a single patient. Until a few years ago, doctors would abandon a treatment if a tumor continued to develop in one place of the body. 

 

A new therapeutic strategy emerges.  

Doctors can keep the therapy that is working for the majority of the body while focusing on the one location where cancer has gotten out of hand. 

Repeat biopsies may also enable the cancer team to pinpoint the specific genetic mutation that is causing a patient's tumor to become resistant to treatment, and then recommend a new medicine that targets that mutation. 

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