Progress in Lung Cancer:
Non-small cell lung cancer (NSCLC) is the most common form of lung cancer, and usually grows and spreads more slowly than small cell lung cancer. There are three forms of NSCLC: adenocarcinomas , squamous cell carcinomas, and large cell carcinomas. Large cell lung cancers tend to grow and spread faster than the other two types. Small cell lung cancer (SCLC) is typically a faster-growing and more aggressive type of lung cancer. Different tumor types can be further described not only by their tissue type, but also by their molecular, or genetic profile. This is also called a gene or molecular signature. Molecular subsets of various cancers are defined by the presence or absence of certain abnormal genes, known as an oncogene, so named since they are thought to be responsible for causing certain cancers.
One molecular subset of non-small cell lung cancer (NSCLC) is defined by a certain abnormal gene, known as the EML4-ALK fusion oncogene. The EML4-ALK fusion oncogene is seen in adenocarcinoma in relatively young patients who are non-smokers or light smokers. Crizotinib is a small molecule inhibitor of the ALK tyrosine kinase, and in patients with the EML4-ALK fusion oncogene, a 57 percent response rate was seen. Additionally, a remarkable 72 percent of patients were progression-free at six months. Treatment with crizotinib was generally well tolerated.
2. Tarceva (erlotinib) is specifically indicated as second-line therapy to treat non-small cell lung cancer in patients who have failed to respond or has ceased responding to at least one round of chemotherapy. It is not indicated as a first-line therapy. A recent phase III trial conducted in China demonstrated that erlotinib significantly prolonged progression-free survival. THe study compared Tarceva with a platinum-based chemotherapy regimen in patients with metastatic NSCLC and a epidermal growth factor receptor (EGFR)mutation. Although similar benefits have been observed with Iressa (gefitinib) in the EGFR mutation-positive population, neither drug has been shown to help people who have non-small cell lung cancer actually live longer.
3. Radiation Therapy –Stereotactic body radiation therapy (SBRT) may be an appropriate treatment option for the initial management of carefully selected patients with non-small cell lung cancer.
Progress in Prostate Cancer:
The FDA approved two important new drugs for prostate cancer in 2010, Jevtana and Provenge.
1. Provenge (sipuleucel-T) was approved in May 2010 for advanced hormone refractory prostate cancer. Provenge is the first therapeutic cancer vaccine approved by the FDA, and is used therapeutically, in that it treats the active disease rather than preventing it. Provenge is used in the hope of stimulating a reaction by the patient own immune system that targets the cancer cells within the body.
2. Jevtana (cabazitaxel) was approved in June 2010 for hormone-refractory metastatic prostate cancer (mHRPC). Similar to docetaxel, Jevatana is also a cellular microtubule inhibitor, which helps arrest tumor cell growth and proliferation. Jevtana helps control the spread of prostate cancer through inhibition of mitosis, interphase cellular functions, and cell growth. Jevtana is always used with the steroid medicine prednisone, and is indicated for the treatment of patients with advanced prostate cancer previously treated with a docetaxel-containing treatment regimen.
3. The FDA also approved Xgeva (denosumab) in patients with bone metastases from prostate cancer. The success of Xgeva was based on positive results seen in three phase III trials in prostate cancer, breast cancer, and other solid tumors. Known as skeletal-related events (SREs), these painful metastases are also seen with other solid tumors other than multiple myeloma.