A discovery at University of Colorado Cancer Center shows testing lung cancer on a molecular level may produce new insights into this deadly disease. Cancer Center member Dr. D. Ross Camidge, director of the thoracic oncology clinical program at University of Colorado Hospital (UCH), turned a chance clinical observation into a new field of discovery in lung cancer. In October 2010, Dr. Camidge and colleagues published a study in the New England Journal of Medicine showing more than half of patients with a specific kind of lung cancer respond positively to a treatment that targets the gene that drives their cancer. Fifty-seven percent of patients with anaplastic lymphoma kinase (ALK) positive advanced non-small cell lung cancer responded to a tablet called crizotinib, an investigational ALK inhibitor. Camidge's latest study, published in the Journal of Thoracic Oncology, shows people with ALK-positive lung cancer also have much better outcomes with an established chemotherapy drug called pemetrexed (trade name: alimta). "We had been running a home-grown clinical trial with pemetrexed in lung cancer when I noticed that some patients were doing astonishingly well on this chemotherapy," said Dr. Camidge, associate professor of medical oncology at the University of Colorado School of Medicine. "Pemetrexed is not like most other chemotherapies. It can be given for long periods of time, often with little in the way of side-effects. However, when someone is given pemetrexed, on average it only takes three to four months before their cancer starts to grow again. But certain people in this trial were responding to the treatment for a year or more. When we started to test their cancers at the molecular level, almost all of those 'super-survivors' turned out to be ALK-positive.
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