Ireland Cancer Center researchers advance lung cancer treatment

April 23, 2007

Researchers at the Ireland Cancer Center of University Hospitals Case Medical Center have developed methods for treating lung cancer cells that have become resistant to new anti-cancer agents.

Led by Balazs Halmos, MD, hematologist/oncologist with the Ireland Cancer Center, the research team followed up on their previous study, published in the New England Journal of Medicine, which found that lung cancer cells can become resistant to novel targeted agents, such as Tarceva (erlotinib), a medication in widespread use for non-small-cell lung cancer (NSCLC). Tarceva is among a new generation of cancer therapies that disrupt the molecular target responsible for stimulating tumor growth. The drug targets the receptor for the epidermal growth factor protein (EGFR) to halt the spread of cancer cells. Clinical applications of the new drug initially yielded good results with approximately 10 percent of patients experiencing complete remission of their disease.

However, in spite of the therapy's initial success, patients inevitably suffered a relapse of their disease. Dr. Halmos' studies confirmed the existence of a mutation, and insertion of this mutation into test cells rendered them resistant to Tarceva. These cells became resistant by undergoing a miniscule molecular change in the EGFR protein that the medication targets. Further analysis revealed that the newly identified mutation was altering the protein's drug-binding pocket and thereby changing the "keyhole" so that the "key" - Tarceva - no longer fit. The researchers found that new second-generation Tarceva-like medications can overcome this change and such drugs are now in development, including in clinical trials at the Ireland Cancer Center.

In this latest study, that received an award at the annual American Association for Cancer Research (AACR) meeting where it was presented earlier this month, Dr. Halmos and his team were able to predict molecular changes the tumors might take next to become resistant to this new class of agents. "We tried to outsmart tumors by anticipating their next moves," says Dr. Halmos, a lung cancer specialist and Assistant Professor of Medicine at Case Western Reserve University School of Medicine. "This research revealed a number of new changes that EGFR can undergo that leads to resistance and also found ways to conquer this next generation of mutants."

The research team developed compounds to overcome the resistance with innovative combinations of medications. "Using these combinations early on can prevent resistance," explains Dr. Halmos. "Through this research, we are redefining our tools and anticipating ways to fight lung cancer."

Other significant presentations at AACR by Ireland Cancer Center physicians include:
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About University Hospitals

With 150 locations throughout Northeast Ohio, University Hospitals serves the needs of patients through an integrated network of hospitals, outpatient centers and primary care physicians. At the core of our Health System is University Hospitals Case Medical Center. The primary affiliate of Case Western Reserve University School of Medicine, University Hospitals Case Medical Center is home to some of the most prestigious clinical and research centers of excellence in the nation and the world, including cancer, pediatrics, women's health, orthopedics and spine, radiology and radiation oncology, neurosurgery and neuroscience, cardiology and cardiovascular surgery, organ transplantation and human genetics. Its main campus includes the internationally celebrated Rainbow Babies & Children's Hospital, ranked best in the Midwest and first in the nation for the care of critically ill newborns; MacDonald Women's Hospital, Ohio's only hospital for women; and Ireland Cancer Center, which holds the nation's highest designation by the National Cancer Institute of Comprehensive Cancer Center. For more information, go to www.uhhospitals.org.

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