Gene Tests Match Up Lung Tumors, Best Treatment

DNA indicates whether chemo will work, experts say

WEDNESDAY, Oct. 3 (HealthDay News) -- Identifying a lung tumor's genetic profile may help doctors determine the best chemotherapy for patients, U.S. research suggests.

"We were able to predict which tumors would be most likely to respond to standard first-line therapy and which would respond better to what has traditionally been a second-line therapy, based on gene expression profiling," lead author and oncologist Dr. David Hsu, of Duke University in Durham, N.C., said in a prepared statement.

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"This represents a big step in the move toward individualized medicine," he said. "This could also make a huge difference in the treatment of patients with late-stage lung cancer, as most of these patients gain the most benefit from their initial treatment strategy."

The findings are published in the Oct. 1 issue of the Journal of Clinical Oncology.

The researchers determined that there are distinct differences in lung tumors' susceptibility to chemotherapy drugs.

In the first part of the study, Hsu's team found that certain genes expressed in non-small cell lung cancer (NSCLC) tumors known to be sensitive to cisplatin (the most commonly-used agent in the treatment of lung cancer) were not expressed in tumors known to be resistant to cisplatin. They also found that genes expressed in the tumors resistant to cisplatin were expressed in tumors sensitive to it.

In the next phase of the research, the team examined a number of second-line therapies for lung cancer, including pemetrexed, which uses a different mechanism of action to fight NSCLC tumors.

"We found the strongest inverse correlation between tumors that were sensitive to cisplatin and those that were sensitive to pemetrexed," senior author and oncologist Dr. Anil Potti said in a prepared statement. "This suggests that some patients who are not likely to respond to cisplatin should perhaps be treated with pemetrexed first."

The findings have formed the basis of a clinical trial -- the first of its kind in lung cancer -- currently being conducted at Duke University.

"These are not experimental drugs; we know they work. It's just a matter of giving each patient the right one on the first try," Potti said.

More information

The American Medical Association has more about lung cancer.

-- Robert Preidt