UF part of trial for new lung cancer drugs

Published: Saturday, March 9, 2013 at 8:38 p.m.
Last Modified: Saturday, March 9, 2013 at 8:38 p.m.

The symptoms could have been many things: a lump in her throat, a wheezing sound, fatigue that no longer allowed her “to run circles around everyone,” said a patient this week at Shands at the University of Florida who requested anonymity.

And the first diagnoses seemed relatively familiar: laryngitis, walking pneumonia — even a flare-up of the emphysema she'd had as a smoker.

But then one night an intense chest pain that roused her from sleep was so crippling that she had to investigate further.

The answer she looked for is not the one she wanted to hear: advanced stage small cell lung cancer.

“Not a good outcome,” she said. “They told me if I did nothing, I would only live a couple more weeks.”

Small cell lung cancer is the kind most commonly connected to smoking.

“I don't recall ever seeing a patient who was not a smoker,” said Dr. Frederic Kaye, the co-director of the thoracic oncology program at UF.

“Advanced stage small cell lung cancer is a very aggressive tumor,” Kaye added, and until recently, the same treatments had been used for about three decades — without much success.

But a new class of drugs that many believe is starting to change the course of cancer treatments may be making some headway with small cell lung cancer — and UF is among two dozen centers worldwide that are taking part in trials to test these drugs.

The drugs are known as antibody-drug conjugates. Commonly known as armed antibodies, and often described as missiles, they carry chemotherapy drugs that are unleashed only once the antibody reaches the targeted cell surface.

“The concept is pretty simple and analogous to a lock and key,” said Dan Junius, CEO of ImmunoGen, the Massachusetts-based company that is developing monoclonal antibodies. Last month, the FDA approved a breast cancer drug called Kadcycla (T-DM1) that ImmunoGen developed along with Genentech/Roche.

The drug had extended median survival in women with advanced breast cancer who were enrolled in a trial by about half a year.

ImmunoGen is working on several other cancer-specific antibodies — among them, IMGN901, or lorvotuzumab mertansine, for advanced lung cancer. UF is one of a dozen centers in the U.S. and two dozen worldwide that is enrolling patients in the trial

“There's a history of frustration of developing new therapies for lung cancer. We recognize that in itself poses a challenge,” Junius said.

Kaye added, “It's clear that small cell lung cancer is a very distinct clinical, biologic and genetic entity from other cancers.”

Both Kaye and Junius say it's too early to tell if IMGN901 will work, but the efficacy of the treatments hinges on identifying the correct antibody, and “I think they picked a good one,” Kaye said.

Like all the antibody-drug conjugates, IMGN901 is promising in that it may “offer the potential of prolonged progression-free and overall survival without complicating the existing toxicities,” Junius said.

One of the advantages of these drugs, broadly known as targeted therapies, is that they hone in on the cancer cells while sparing healthy tissue.

The patient cited at the beginning of this story is one of a handful of patients enrolled at the trial at UF, and so far she reports few side effects to the drugs.

The trial might give her one good year of life, she said, and perhaps more depending on how her body responds to the treatment.

“I feel good about it because even if it does nothing for me, then there's the possibility it can for someone else.”

Contact Kristine Crane at 338-3119, or kristine.crane@gvillesun.com.

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