Personalized lung cancer treatments are already out there, researchers conclude

Squamous cell lung cancer--among the most common forms of the disease--has no targeted therapies. But it turns out that there are a number of tumor mutations for which new drugs already under development might work, according to new research, reflecting a significant advance in the bid to advance personalized medicine.

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Research led by Dr. Matthew Meyerson of the Dana-Farber Cancer Research Institute in Boston and involving more than 300 other authors made the finding. They conducted their research as part of The Cancer Genome Atlas (TCGA), a coordinated effort led by the National Cancer Institute and the National Human Genome Research Institute (both of the National Institutes of Health) to use genome sequencing and other technologies to boost the understanding of the molecular basis of cancer. Details are published in the journal Nature and the findings are highlighted with great analysis in The New York Times.

Among the new therapeutic targets: Three families of tyrosine kinases (enzymes mutated in cancer that turn on or off many cellular functions). They are an important class of enzymes, TCGA researchers say, which have also been explored as possible therapeutic targets in preclinical studies involving other cancers. Additionally, researchers found new mutations that reduce the function of the HLA-A gene tumors. This is crucial, because HLA helps the immune system separate foreign invaders from the body's healthy cells, the scientists explain. Overall, over 60% of tumor cells analyzed from 178 squamous cell lung cancer patients had gene alterations that could benefit from new cancer drugs already on the market or now under development, the article explains. 
"What we found will change the landscape for squamous cell carcinoma," lead author Dr. Matthew Meyerson of Dana-Farber told The New York Times. "I think it gives hope to patients."

The NYT article notes that this new research has only become possible within the last few years because DNA sequencing has advanced so much. Researchers can now, for example, scan the entire quantity of a cell's DNA instead of looking at each of a cell's 21,000 genes sequentially.

While the work is significant, there are challenges ahead. Scientists will have to determine how much damage they can inflict on a given squamous cell variation by targeting a particular tumor. (Not all mutations are key to a tumor's survival, the story correctly points out.) And researchers will have to think big, and form a clinical trial consortium so they reach enough patients with a particular form of squamous cell lung cancer mutation to get a statistically high enough sample for a given treatment option.

At a minimum, the researchers expect that future work will spur new clinical trials, in part involving tyrosine kinase inhibitors. That means leukemia drugs such as Novartis' ($NVS) Gleevec and Pfizer's ($PFE) Bosulif could provide added benefit to certain squamous cell lung cancer patients whose specific tumor mutations match the treatment.

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- read the release
- check out the NYT coverage (subs. req.)
- here's the journal abstract