Posted: August 8, 2014

Dr. Stark gave Medical Grand Rounds at EVMS on August 20, 2014.  He spoke about the new ways of looking at lung cancer — specifically the role of genetic mutations in guiding treatment with drugs that have recently been developed to target those mutations, while leaving normal cells alone.  Recent publications suggest that for patients with lung cancer whose tumors contain certain mutations (only the tumors have the mutations; the rest of the cells of the body do not) using drugs targeted against the protein products of those mutations (typically enzymes) results in a better outcome than that seen with conventional chemotherapy.  His latest lung cancer talk can be viewed here.  Dr. Stark comments, “The entire way we treat lung cancer, once the tumor is too advanced to be cured with surgery alone, is undergoing a quiet but rapid evolution.  The treatment of other diseases will follow.  Breast cancer already has.  We will, in these postings, stay abreast of the latest developments.  ”

Update 2023: many additional mutations have been identified, mostly with adenocarcinoma of the lung, since this original posting in 2014.  Patients who respond to EGFR drugs and then relapse usually develop drug resistance.  At that time additional “downstream” mutations can be identified if a metastatic lesion is biopsied.  New drugs have teen developed to address this issue and have been found highly effective.  In patients whose tumors do not possess an actionable mutation, immunotherapy has proved extremely useful — a subject for another discussion.  This is a fluid and rapidly changing field.  Stay tuned….