Certain lung cancer patients benefit from radiation and chemotherapy

30 Dec 2014

In a clinical trial, stereotactic body radiation therapy (SBRT) combined with specific chemotherapy improved survival among certain lung cancer patients. In particular, it more than doubled survival rates for some stage 4 non-small cell lung cancer patients.

Combining stereotactic body radiation therapy and erlotinib

The combination of the chemotherapy regimen, erlotinib, with stereotactic body radiation therapy, known as SBRT, improved overall survival time to 20 months compared to historic 6- to 9-month survival times among erlotinib-only treated patients. The combination improved progression free survival – the time without the reappearance of cancer − from the historical two to four months to 14.7 months for similarly selected lung cancer patients.

“Our approach dramatically changed the pattern of relapse. We saw a shift in failure from existing, local sites to new, distant sites,” said senior author Dr. Robert Timmerman, Director of the Annette Simmons Stereotactic Treatment Center, and Vice Chairman of Radiation Oncology at UT Southwestern. “This shift resulted in a surprisingly long remission from the reappearance of cancer in treated patients.”

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Phase 2 clinical trial with 24 patients

This Phase 2 clinical trial involved 24 patients with stage 4 non-small cell lung cancer (NSCLC) whose cancer has continued to spread during their initial therapy. Such patients typically have poor survival rates, and SBRT is not typically used in these patients, said first author Dr. Puneeth Iyengar, Assistant Professor and Director of Clinical Research of Radiation Oncology, and co-leader of the Simmons Cancer Center Thoracic Oncology Group.

About Stereotactic Body Radiation Therapy (SBRT)

The revolutionary SBRT technique is a type of radiation therapy in which a few very high doses of radiation are delivered from multiple angles to small, well-defined tumors. The goal is to deliver a radiation dose high enough to kill the cancer, while minimizing exposure to surrounding healthy tissue and organs, explained Dr. Timmerman, who directs Clinical Research and the Image-Guided Stereotactic Radiation Therapy in the Department of Radiation Oncology.

SBRT has been shown to offer better cure rates in certain instances, particularly for cancers that have metastasized, said Dr. Timmerman, Professor of Radiation Oncology and Neurological Surgery, who was one of the first researchers in the world to use the SBRT techniques initially developed for brain tumors to treat cancer in the body.

“Technologies have developed in the last few years that have yielded game-changing, paradigm-shifting approaches, allowing us to reconsider how radiation is delivered in combination with surgery, chemotherapy, and other systemic therapies,” said Dr. Timmerman, who served as the lead investigator in several national trials designed to evaluate the efficacy and safety of SBRT to treat cancer in the lung, liver, spine, and prostate. “I am motivated by the need I see every day in the clinic to provide better treatments for our patients.”

The results are reported in the Journal of Clinical Oncology of the American Society of Clinical Oncology.

University of Texas Southwestern researchers involved in the trial

Other UT Southwestern researchers included Dr. Hak Choy, Chairman of Radiation Oncology, who holds The Nancy B. & Jake L. Hamon Distinguished Chair in Therapeutic Oncology Research;  Dr. Chul Ahn, Professor of Clinical Sciences;  Dr. David Gerber, Associate Professor of Internal Medicine; Dr. Jonathan Dowell, Associate Professor of Internal Medicine; Dr. Randall Hughes, Associate Professor of Internal Medicine; Dr. Ramzi Abdulrahman, Associate Professor of Radiation Oncology; Postdoctoral researcher Dr. Zabi Wardak; and researchers from the University of Colorado School of Medicine.

The trial was supported by OSI Pharmaceuticals. Dr. Timmerman reported receiving research funding from Varian and OSI Pharmaceuticals; Dr. Gerber reported receiving research funding from Genentech and OSI Pharmaceuticals; Dr. Ahn reported a consulting/advisory role with Celltrion; Dr. Dowell reported receiving research funding from Verastem, MedImmune, Eli Lily, MolMed, Peregrine and a speaker’s bureau role with Genentech; Dr. Hughes reported stock or other ownership with Pfizer; Dr. Choy reported research funding from Celgene and a consulting/advisory role with Bayer and EMD Serono.

About UT Southwestern Medical Center

UT Southwestern, one of the premier academic medical centers in the USA, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty includes many distinguished members, including 6 who have been awarded Nobel Prizes since 1985. Numbering approximately 2,800, the faculty is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide medical care in 40 specialties to about 92,000 hospitalized patients and oversee approximately 2.1 million outpatient visits a year.

 

Source: University of Texas Southwestern Medical Center
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