We are in an era of targeted therapy for cancer — treatment based on genetic mutations present in cancer that make its DNA different from that in normal cells. The original treatment invented for this purpose was Imatinib, or Gleevec, a miraculous treatment for chronic myeloid leukemia based on a unique gene created by a swap of genetic material between two chromosomes. In the last twenty years a large array of new drugs have been designed to take advantage of these mutations. A common cancer gene KRAS, has stubbornly resisted this approach. Now comes a new drug, still investigational, not ready for commercial use, Sotorasib, that offers promise against this gene. In a recent paper published in the New England Journal of Medicine, oncologists at MD Anderson and Memorial Sloan Kettering Cancer Center, tested this drug against incurable cancers in over 100 patients, about half of whom had advanced lung cancer. The lung cancer patients fared the best, with about a third showing major reductions in tumor size. At the time of the publication of the paper, many of these patients were still responding.
Dr. Stark comments, “The KRAS gene is the most commonly mutated gene in human cancers. It has been on the wishlist of investigative oncologists for decades. Finally scientists have taken its structure and designed a drug that gums up the works, much as Gleevec did for CML. This is a huge advance.”