LungBlog

Benjamin Franklin famously remarked that only two things are inevitable: death and taxes. In this era of superior diagnostics, timely treatment, miracle drugs, and breathtaking medical innovation, he might have been tempted to add a third item to the list — serious long-term illness.

Almost every family experiences one: the sort of reverie-piercing, life-rending health event or diagnosis that smacks you upside the head without warning, challenging your finances, belief system, priorities, and plans — frequently when you’re on the phone with your health insurer.

Analyzing the genes expressed by cancer cells allows for a better understanding of that patient’s specific disease and in turn, a more personalized approach to treatment. But obtaining the RNA from a tumor in the lungs in order to conduct the genetic analysis is a challenging prospect. Currently, lung cancer researchers are limited to using RNA extracted from early-stage tumors removed during surgery. The small quantities of tissue extracted during routine diagnostic biopsies have not been useful to researchers, due to their small size and the variety of ways they have been processed.

Since oftentimes surgery is not an option in advanced lung cancer, genetic analysis of the tumor is critical, there is a need to obtain good quality RNA samples from tumor tissue taken via biopsy, no matter how the biopsy procedure is conducted.

WAYNE, N.J. and EMERYVILLE, Calif., June 14 /PRNewswire-FirstCall/ — Bayer HealthCare Pharmaceuticals and Onyx Pharmaceuticals, Inc. (Nasdaq: ONXX) today announced that the final analysis of the Phase 3 NExUS (NSCLC research Experience Utilizing Sorafenib) trial evaluating Nexavar® (sorafenib) tablets in patients with advanced non-squamous non-small cell lung cancer (NSCLC) showed that the study did not meet its primary endpoint of improving overall survival in the first-line setting.  NExUS evaluated Nexavar versus placebo in combination with two chemotherapeutic agents, gemcitabine and cisplatin.  A positive secondary endpoint of progression-free survival (PFS) was observed in the trial.  The safety and tolerability of the treatment triplet was as expected and did not show any new or unexpected toxicities.  Data from this study are expected to be presented at an upcoming scientific meeting.

Nexavar is currently marketed worldwide for the treatment of hepatocellular carcinoma (HCC), or liver cancer, and advanced renal cell carcinoma (RCC), or kidney cancer.

Decision Resources, one of the world’s leading research and advisory firms focusing on pharmaceutical and healthcare issues, forecasts that the non-small-cell lung cancer drug market in Brazil will reach $240 million by 2014. Factors fuelling this growth include a slight but steady annual increase in the number of incident cases, greater uptake of higher-priced brands of chemotherapy, targeted regimens and maintenance treatment (all in the advanced setting) and modest uptake of novel targeted agents.

“Through the Brazilian national health system, virtually all diagnosed patients have access to treatment. However, a small but lucrative segment of patients with private health insurance largely drives the use of premium-priced novel chemotherapy and targeted agents,” stated Decision Resources’ Analyst Janie Cox, Ph.D. “During our 2009 – 2014 study period of Brazil’s non-small-cell lung cancer drug market, collective sales of targeted therapies such as Roche’s Avastin and Tarceva, and AstraZeneca’s emerging agent Iressa, are expected to grow 21 percent annually while sales of Eli Lilly’s novel chemotherapy agent, Alimta, are expected to grow 15 percent annually.”

Cancer stem cells have enticed scientists because of the potential to provide more durable and widespread cancer cures by identifying and targeting the tumor’s most voracious cells. Now, researchers at Children’s Hospital Boston and their colleagues have identified cancer stem cells in a model of the most common form of human lung cancer and, more significantly, have found that the cancer stem cells may vary from tumor to tumor, depending upon the tumor’s genetic signature.

“Our study shows the cancer stem cell hypothesis is true in some lung cancers,” said senior author Carla Kim, Ph.D., an assistant professor in the Stem Cell Program at Children’s Hospital Boston and the department of genetics at Harvard Medical School (HMS). “It also shows, from one lung cancer to another, the cancer stem cells are not the same.”

Cancer stem cells are a subset of cancer cells believed to elude conventional treatments and eventually regenerate a tumor. Experimentally, they show up as cells that can be extracted from a tumor and transplanted to form a new tumor, from which the same tumor-propagating cells can again be extracted and transplanted with the same result. According to Kim, this is the first serial transplantation study to identify lung cancer tumor-propagating cells.

Cancer stem cells have enticed scientists because of the potential to provide more durable and widespread cancer cures by identifying and targeting the tumor’s most voracious cells. Now, researchers at Children’s Hospital Boston and their colleagues have identified cancer stem cells in a model of the most common form of human lung cancer and, more significantly, have found that the cancer stem cells may vary from tumor to tumor, depending upon the tumor’s genetic signature.

“Our study shows the cancer stem cell hypothesis is true in some lung cancers,” said senior author Carla Kim, PhD, an assistant professor in the Stem Cell Program at Children’s Hospital Boston and the Department of Genetics at Harvard Medical School (HMS). “It also shows, from one lung cancer to another, the cancer stem cells are not the same.”

Kidney problems are the second serious condition linked to the cancer drug. Last year it was found that some patients on Avastin were at elevated risk of intestinal perforations.

A widely prescribed cancer drug noted for its ability to choke off blood vessels that help tumors grow can cause significant kidney damage in some patients, a team of Long Island scientists has found.

Kidney problems are the second serious condition linked to Avastin and pinpointed in research conducted by Dr. Shenghong Wu and colleagues at Stony Brook University Medical Center. Last year Wu and his team found some patients on the drug were at elevated risk of intestinal perforations.

Patients newly diagnosed with metastatic non-small cell lung cancer (NSCLC) who received gefitinib (Iressa) had significantly higher response rates and longer progression-free survival compared with patients who received carboplatin plus paclitaxel (73.7 percent versus 30.7 percent and 10.8 months versus 5.4 months, respectively), according to results of a phase III trial conducted in Japan. The results were published in the June 24 New England Journal of Medicine.

All patients enrolled in the study had epidermal growth factor receptor (EGFR) mutations that were sensitive to the tyrosine kinase inhibitor (TKI) gefitinib. The patients did not have the resistant EGFR mutation T790M, and they had not been previously treated with chemotherapy.

The researchers, led by Dr. Makoto Maemondo of the Miyagi Cancer Center in Miyagi, Japan, believe that this study establishes the clinical benefit of an EGFR tyrosine kinase inhibitor as first-line therapy in patients with NSCLC and sensitive EGFR mutations.“If gefitinib is administered as second-line or third-line treatment,” he and his colleagues wrote, “patients may miss the opportunity to receive treatment because of rapidly progressive disease during or after first-line treatment.”

They also found an unexpectedly high number of these jumping genes, known as transposons, in lung tumors and said they may hold clues to the highly deadly cancer.

“We found that if you have a child, the child could have one or more new copies of these transposons that you don’t have,” Scott Devine of the University of Maryland School of Medicine said in a statement.

“From these findings, we predict that there is going to be more variation in human genomes than scientists first believed,” added Devine, who led the research while at Emory University in Atlanta.

Bioengineered organs, still largely the stuff of sci-fi, may have just moved a step closer to reality with reports that scientists have successfully implanted lab-made lung tissue into living rats.

The fully functional tissue can exchange oxygen and carbon dioxide, the key role of the lungs.

The scientists–led by a team at Yale University–used a chemical treatment to remove all existing cells from adult rat lungs, keeping the structure of the airways and vascular system intact to later serve as a sort of “scaffold” for the growth of new lung cells.

They then cultured a combination of lung cells using a bioreactor designed to mimic the fetal lung environment and repopulated the “decellularized” rat lung with the engineered cells. When implanted into rats for short intervals of 45 to 120 minutes, the new tissue exchanged gas in a manner similar to that of natural lungs.