The treatment of non-small-cell lung cancer has undergone a revolution in the last ten years with the development of drugs that target mutations to the DNA of the lung cancer cells that are not present in the normal cells in the body. The latest in this story of drug development targets the ROS-1 cancer gene. One of a family of tyrosine kinase receptor proteins — molecules that drive the growth of the cancer — the ROS-1 oncogene is present in a small percentage of lung cancers — typically adenocarcinomas in young non-smokers. The theoretical benefit of this drug over the previously developed other drug for this mutation — Crizotinib — is its penetration into the brain. This would be useful in patients with brain metastases. Published in the Journal of Clinical Oncology in January 2021 is a study by a group of researchers all over the world. Click here for the abstract. Dr. Stark can provide the entire article; fill out the form on the right to request it. They treated 161 patients whose tumors harbored this mutation. 60% had received prior chemotherapy; 35% had brain metastases. This group would otherwise be expected to have a very short life expectancy. Two thirds of the patients had major benefit from the treatment, with almost ten percent experiencing total disappearance of their cancer. Many of these remissions continue to this day.
Dr. Stark comments: the treatment of this kind of lung cancer has undergone a revolution from the days when everybody got chemotherapy, and it didn’t work very well. We are on the brink of converting lung cancer to a chronic disease like diabetes, rather than the uniformly rapidly fatal illness it has always been.