There are two major subtypes of lung cancer: Non-Small Cell Lung Cancer (NSCLC), which accounts for 85% of all cases, and Small Cell Lung Cancer (SMLC). About 60% of NSCLC are unresectable at diagnosis, hence, the poor prognosis – ten to twelve months survival when treated with platinum-based chemotherapy. Treatment options are evaluated based on the histologic subtype and the presence of mutations to determine the the best combination of molecular therapies for treatment. Ten to twenty percent of patients with NSCLC have a mutated epidermal growth factor receptor, most commonly. a deletion in the in-frame of exon 19 (around amino acid 747 to 752) or a L858R point mutation of exon 21. On June 1, 2016, the FDA approved the first blood test (liquid biopsy) companion diagnostic to determine whether these mutations are present. Continue reading
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Combination Therapy of Immune Checkpoint Inhibitors to Combat Lung Cancer – James P. McCauley, Contributor
Researchers at AstraZeneca have completed a small-scale study which demonstrated the synergistic benefit of utilizing two immunotherapy drugs to combat non-small cell lung cancer (NSCLC) over just a single immunotherapy drug. The study found that utilizing an immune checkpoint inhibitor for PD-1, called durvalumab, in combination with another immune checkpoint inhibitor for CTLA-4, called tremelimumab, had a tumor response rate of 23% for metastatic NSCLC. Researchers at AstraZeneca are, indeed, confident that combination immune checkpoint therapy is the key to developing more efficient immunotherapies to target and effectively treat cancer. Continue reading
Combined Endoglin and VEGF Monoclonal Antibody Therapy in Cancer – Subasinghe Nissanga A Dias, Contributor
Blood vessel formation (angiogenesis) is an important pathologic process in solid tumors. The liberation of vast amounts of vasoendothelial growth factor (VEGF), which attracts endothelial cells, is responsible for angiogenesis. Continue reading
The Roles of P53, BRCA1, and PTEN in Hereditary Cancers – Lauren Fitzgerald, Contributor
Cancer results from accumulated mutations in the cancer cell’s genome. These mutations can occur spontaneously in any cell throughout an individual’s lifetime, often increasing with age or exposure to carcinogenic or mutagenic compounds. These are called somatic mutations that do not exist in every cell, and cannot be passed along from one generation to the next. However, in approximately 5 to 10% of all cancer cases, mutations are passed along through the germ line and can predispose an individual to various types of cancers. Continue reading
Olaratumab Receives Priority Review for Soft Tissue Sarcoma
The platelet derived growth factor receptor-α (PDGFRα) monoclonal antibody, olaratumab (IMS-3G3) by Eli Lilly, received Priority Review from the FDA on the strength of data from its Phase II trial in patients with soft tissue sarcoma (STS). The drug already received Orphan Drug, Breakthrough Therapy, and Fast Track designations from the agency. Continue reading
Early Cancer Detection Company, Grail, Led by Former Google VP – Ashley P. Angelo, Contributor
Healthcare firm Grail, which has been formed by the gene sequencing company Illumina, named Jeff Huber, former Google X Senior Vice President, as its CEO in February. With Huber’s experience in developing large-scale data, Grail hopes to improve gene sequencing technology used in blood tests for early detection of cancer in asymptomatic patients so that immunotherapeutic strategies, as opposed to toxic chemotherapy, can be employed with the goal of curing cancer. Continue reading
Celldex’s ADC Glembatumumab-vedotin for Triple Negative Breast Cancer
Antibody drug conjugate Glembatumumab vedotin (GV) is in late phase 2 trials for patients with triple negative breast cancer (TNBC) – those whose tumors do not express estrogen, progesterone, or HER-2. Approximately 15% of breast cancer patients have TNBC; it is an important area of research for both researchers and clinicians alike because: Continue reading
FDA Grants Antibody-Drug Conjugate Breakthrough Designation in Triple Negative Breast Cancer – Amani Khawatmi, Contributor
The FDA granted Breakthrough Therapy Designation to Sacituzumab govetican (IMMU-132) for treatment of triple-negative breast cancer (TNBC). A diagnosis of triple negative breast cancer means that the three most common types of receptors known to fuel most breast cancer growth–estrogen, progesterone, and the HER-2/neu gene– are not present in the cancer tumor. This means that the breast cancer cells have tested negative for hormone epidermal growth factor receptor 2 (HER-2), estrogen receptors (ER), and progesterone receptors (PR). Since the tumor cells lack the necessary receptors, common treatments likehormone therapy and drugs that target estrogen, progesterone, and HER-2 are ineffective.
Saliva Test to Detect EGFR Mutations and Guide Therapy in Lung Cancer
A new technology called electric field–induced release and measurement (EFIRM) is able to detect biomarkers in saliva for non-small cell lung cancer (NSCLC). The test detects circulating tumor DNA (ctDNA). It is able to detect actionable EGFR (epidermal growth factor receptor) mutations in NSCLC patients with 100% concordance with biopsy-based genotyping, Dr Wong (study author) said, and it can detect the most common EGFR gene mutations that are treatable with TKIs (tyrosine kinase inhibitors), such as gefitinib (Iressa, AstraZeneca Pharmaceuticals LP) or erlotinib (Tarceva, Genentech/Roche). Continue reading
Additional Drivers and Pathways in Basal Cell Carcinoma
The Sonic hedgehog (Hh) pathway is known to be important in basal cell carcinoma (BCC), which as an extremely common skin cancer that only rarely invades and metastasizes. An approved drug for patients with advanced BCC, Vismodegib (Erivedge), interferes with the Hedgehog pathway. The Patched (12 membrane-spanning receptor protein) normally disables Smoothened (7 membrane-spanning protein) rendering it functionally inert. This maintains transcription factor Gli in a cleaved state, acting as a transcriptional repressor. When Hedgehog proteins bind to Patched, Smoothened is released and protects Gli from cleavage. Uncleaved Gli travels to the nucleus and is an inducer of transcription, increasing Cyclin D1 and stimulating the cell cycle (proliferation). Vismodegib blocks the actions of Smoothened. It is administered orally in 150 mg capsules.