May 9, 2014 — There’s a new treatment for patients with ALK+ (positive) non-small-cell lung cancer (NSCLC), which can occur in non-smoking lung cancer patients. Previously in clinical trial at Huntsman Cancer Institute, the new drug, Zykadia™/ ceritinib, is part of a new generation of treatments that targets a specific genetic defect in the tumor. Dr. Sunil Sharma discusses the medication and its uses for treating this cancer.

Interview

Host: There's an exciting new drug for the treatment of lung cancer. We'll explore that next, on The Scope. Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope. So there's a brand new breakthrough therapy drug for lung cancer that's been approved by the FDA four months ahead of schedule. We're talking with Dr. Sharma from Huntsman Cancer Institute. Is this an exciting thing?
Dr. Sharma: It's incredibly exciting from a couple of perspectives. One is that this drug was approved for a genomically defined or a genetically defined population of lung cancer, so kind of advancing the idea that you have personalized oncology, or personalized medicine, where you can identify a genetic defect in the tumor of a patient and then treat it specifically with a drug that is designed to attack that particular genetic mutation. So that's one reason and the other reason is that this drug was actually approved in record time, from the time we started a Phase 1 trial, which is the earliest form of a clinical trial here at the Huntsman Cancer Institute, along with other centers around the world, and from the time the Phase 1 trial actually finished, literally within a year the drug has been approved for general use in the patients, for patients all around the world, all around the United States, in the case. Host: So record time, what was the difference with this drug as opposed to others?
Dr. Sharma: Usually, in cancer drugs, when we developed treatments in the past, unfortunately, drugs haven't been incredibly effective, and what this drug trials or what this drug shows is that if you can define a genetic aberration in the cancer and you can specifically target it then the drug can be highly effective, in which case the Food and Drug Administration or the FDA is liable to approve the drug, if it's highly effective in a very short period of time. Host: Yeah, so it sounds like also it's very exciting from the standpoint that it kind of changes cancer treatment to some extent. It's a very pinpoint laser sort of a treatment. Dr. Sharma: Exactly, as opposed to doing what we've done for a long time, which also works, but doesn't work necessarily as well, which is chemotherapies, where, you know, you target the cancers in, sort of a more non specific way, here we're, as you mentioned, laser pinpoint treatment, leading to highly effective therapy, leading to a very quick approval by the FDA. Host: So this is exciting because lung cancer is the deadliest cancer. Dr. Sharma: Yes, it is. Host: There are two types of lung cancer, which one does this treat?
Dr. Sharma: Yeah, so this actually treats a particular subset of non-small cell lung cancers. There are two kinds of lung cancer, one is called the small cell lung cancers and other one called non-small cell lung cancer, and this actually treats a subset of the non-small cell lung cancers. So it's not necessarily a drug that is applicable to the vast majority of non-small cell lung cancers, but if a patient's tumor has this particular genetic change in the non-small lung cancer, then this drug is extremely effective. Host: And are there side effects to this particular drug?
Dr. Sharma: Very mild actually, that is the other great thing about some of these newer treatments, are that they generally have mild side effects, for instance, in this case, most of the side effects were related to some gastrointestinal disturbance, but not any chemotherapy like side effects, like hair loss or bone marrow problems or incredible fatigue or anything like that. Host: And for people that have this particular type of cancer, is it a cure?
Dr. Sharma: It is actually not a cure, it turns out that basically the drug can work up to seven months to a year for the majority of the patients, after which we unfortunately have to get them newer treatments, but what is going to be tried now is this treatment is likely to be tried in earlier stages of the same kind of genomic mutation, in which case it might actually enhance the ability to cure this cancer. Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.