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New Therapies for Lung Cancer

Posted Aug 24 2008 1:49pm
ANNOUNCER: New therapies are prolonging the lives of patients with lung cancer and improving their quality of life.

JACK WEST, MD: There is still a lot of pessimism among patients and even among other doctors about the value of giving treatment to patients with lung cancer. Some are skeptical that we can improve cure rates and some people who we can't cure, there is a perception that it's not worth bothering with treatment.

What we have done in the last ten years and especially in the last five years is develop treatments that, in a curative setting, can improve the cure rates and, in the non-curative setting, can improve survival or, if keeping the same survival, can do that with fewer side effects for patients.

LUIS RAEZ, MD: The chemotherapy that we use nowadays, the patient can go to work, try to have his life as normal as possible. The chemotherapy is outpatient, so you come to the center, you get your chemotherapy, and hopefully the rest of the week you are not sick.

JORGE E. GOMEZ, MD: The most important thing to remember is that we have many drugs for lung cancer. Some of those include the basic drug, which is cisplatin, in combination with other drugs such as Taxotere, paclitaxel, gemcitabine, pemetrexed. There are multiple other drugs that can be used.

LUIS RAEZ, MD: The problem with chemotherapy and the mechanism of action is they damage the DNA of the cancer cell, but they also damage your healthy cells.

ANNOUNCER: And many of the side effects seen with chemotherapy stem from this collateral damage done to healthy cells. So in addition to traditional chemotherapies, doctors are also treating patients with newer targeted therapies.

JORGE E. GOMEZ, MD: We've been trying to target the actual cause of the cancer. The actual metabolic or biological mechanisms that force the cell to become malignant in an effort to reverse that process.

HOWARD WEST, MD: There are intelligently designed treatments that we have that are specifically focusing on a particular molecule on a cancer cell that is not shared on many of the cells of the body. And the idea is that a targeted therapy can hit the cancer with fewer side effects for a patient.

ANNOUNCER: Tarceva is such a newly approved targeted drug.

HOWARD WEST, MD: Erlotinib or Tarceva, which is a pill that was shown to improve survival as second- or third-line treatment after chemotherapy in patients with advanced lung cancer.

ANNOUNCER: Tarceva targets the protein her1/egfr, the epidermal growth factor receptor.

LUIS RAEZ, MD: This drug looks for the receptor, enters the receptor, and shuts down the growth of the cancer cell.

HOWARD WEST, MD: There's a newer targeted therapy called bevacizumab or Avastin that targets the tumor blood supply and that has been added to carboplatin and paclitaxel and is shown to improve survival compared to just the two chemo drugs without the Avastin, the bevacizumab in a trial.

ANNOUNCER: Targeted therapies such as tarceva and avastin may have unique side effects and patients should discuss these with their doctor before taking the drugs.

Researchers are also studying immunotherapies.

JORGE E. GOMEZ, MD: Some of the immunotherapies are vaccines where we inject substances into the body and have the body create antibodies against those molecules that are also present on cancer cells and, in that way, try to kill cancer cells. Other immunotherapies are actually antibodies that are created either artificially or grown in mice that are injected into humans geared towards specific targets on cancer cells, also to either let the cell die or to kill the cell.

JACK WEST, MD: You can also potentially train the immune cells of your own body to recognize the tumor cells. That may involve taking out some blood or taking out the white cells of the body that do the infection fighting, training them in a lab setting to recognize and fight against a cancer and then actually injecting back those same cancer cells into the patient so that they can teach the rest of the body how to fight that cancer and that is really being studied in a pretty advanced way right now.

ANNOUNCER: With all these new drugs, and the promise of immunotherapies, lung cancer patients are living longer and experiencing fewer treatment side effects.

LUIS RAEZ, MD: Hopefully in the next years we will have very exciting times for our patients. Lung cancer hopefully will be from an incurable disease, will be making maybe a chronic disease, like diabetes or hypertension, that you do not get cured, however, you may survive 20 or 30 years. That's our goal. At least, if we cannot cure the lung cancer yet, we can provide you 10 or 20 years of life.

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