Sr. Dowlati Develops New Predictor for Lung Cancer
Treatment and Survival
Results announced at ASCO cancer conference
Research from the Division of Hematology and Oncology and the
Ireland Cancer Center of University Hospitals of Cleveland has
found a promising, novel biomarker that may be used to predict
the survival of patients with advanced lung cancer and their
response to treatment. Afshin Dowlati, MD, presented this study
June 5 at the annual meeting of the American Society of Clinical
Oncology (ASCO).
Dr. Dowlati found that patients with a low level of the biomarker
ICAM had a better chance of survival and an increased response
to chemotherapy. Dr. Dowlati analyzed data from a major national
study, released at ASCO in 2005, that found the monoclonal antibody
Bevacizumab (Avastin), in addition to standard therapy, was
more effective than standard treatment alone for patients with
advanced, non-squamous non-small cell lung cancer.
The analysis indicated that patients with low levels of ICAM
(intercellular adhesion molecule -1), had a higher response
rate to treatment (29% versus 13%) than patients with high ICAM
levels. Patients with low ICAM levels also had a significantly
better overall survival rate.
"We believe this research confirms a significant new prognostic
marker in lung cancer," says Dr. Dowlati, who is also assistant
professor at Case Western Reserve University School of Medicine.
"Previously, it has been a challenge to identify those
patients that will respond best to treatment and what their
outcomes will be. This biomarker appears to serve as a much
better predictor than gender, patients’ overall health
and sites of metastases." These findings confirm a pilot
study performed 3 years ago at Ireland Cancer Center by Drs.
Dowlati, Scot Remick and Keith McCrae, an expert in blood vessel
disorders found in cancer.
Data was analyzed from a phase III study, conducted by the
Eastern Cooperative Oncology Group (ECOG), which involved 878
patients nationwide who were randomized to standard chemotherapy
- paclitaxel and carboplatin - with and without Bevacizumab.
Patients who received Bevacizumab lived 2.5 months longer and
had a 24.8% shrinkage in their tumors versus 9.4% shrinkage
in patients who had chemotherapy alone. Bevacizumab is an anti-angiogenesis
inhibitor designed to prevent the formation of new blood vessels
to the tumor.
"This represents a major step forward in treating patients
with advanced lung cancer," says Stanton Gerson, MD, Director
of the Ireland Cancer Center and the Case Comprehensive Cancer
Center. "This biomarker may help clinicians identify patients
who are candidates for treatment and who will benefit from it.
This finding is likely to be useful in other cancers as well."
Lung cancer is the second most commonly diagnosed cancer and
is the leading cause of cancer-related death in both men and
women in this country. An estimated 163,510 deaths from lung
cancer occurred in 2005 in the United States, accounting for
about 29 percent of all cancer-related deaths in the nation.
Other significant presentations at ASCO by Ireland Cancer Center
physicians include:
Scot Remick, MD, presented an update to a Phase II clinical
trial evaluating Ca4P (combretastatin) as a treatment for advanced
anaplastic thyroid cancer. Ireland researchers found that 29%
of patients experienced stability of their aggressive cancer
with this anti-angiogenesis inhibitor.
"Without a doubt, we have observed patient benefit from
Combretastain therapy in anaplastic thyroid cancer, which is
one of the most aggressive types of cancer," says Dr. Remick,
Associate Director for Clinical Research at Ireland and Professor
of Medicine at Case. "In some cases, patient response has
been extraordinary, and supportive of the complete response
observed in one patient who is still cancer free today -- more
than six years after participating in our initial Phase I clinical
trial. We believe that the data presented today provides further
evidence of the biological activity of this compound and that
additional clinical trials are warranted to investigate the
potential clinical benefit of combining Combretastatin with
other therapies, including chemotherapy."
Janice Lyons, MD, on behalf of the breast cancer team of the
Ireland Cancer Center, presented findings that the use of traditional
chemotherapy, docetaxel, with bevacizumab (Avastin) is well
tolerated in patients with locally advanced breast cancer. This
Phase II study analyzed docetaxel alone compared with its use
in combination with bevacizumab and found no significant differences
in side effects between the two groups.
Panos Savvides, MD, on behalf of the head and neck cancer team
of the Ireland Cancer Center, presented findings from a Phase
I study of the use of Tarceva in combination with docetaxel
in successfully treating advanced head and neck cancers. This
promising research will be followed up by a Phase II study into
the efficacy of Tarceva, an EGFR tyrosine kinase inhibitor.
Along with colleagues at the University of Nairobi and the Uganda
Cancer Institute, Dr. Remick presented findings that oral chemotherapy
is effective in the treatment of AIDS-related non-Hodgkin’s
lymphoma in East Africa. In a resource-limited setting where
the use of intravenous treatment is challenging, the use of
oral medications has comparable outcomes to its use in the United
States.
