Why “One Size Fits All” Therapies Won’t Work for All Lung Cancers

Creating Personalized Treatments at the Molecular Level
Wednesday, August 21, 2013 - 3:30pm
Associate Professor, Department of Medicine

What is often most difficult in the general treatment of lung cancers is understanding the specific complexities of each unique case. For decades, doctors and the medical community alike have lumped all lung cancers together as one entity. Over those same decades, however, advances in research and treatment have taught us that there are hundreds of variant cancers within the larger category of lung cancer.

Due to molecular studies, we now know that different tumors have different underlying biologies. Developing successful treatment approaches for a set of many different types of lung cancer is now based on creating different, more targeted therapies for each distinctive case.

Examples of successful therapies include erlotinib and crizotinib that specifically target abnormalities in the proteins called EGFR and ALK, respectively. However, these two protein abnormalities make up fewer than 20 percent of all lung cancer cases diagnosed to date.

Here at Roswell Park, we are part of worldwide efforts to refine advanced diagnostics and therapies to create personalized medicine.

We are opening up a clinical research study within a few months for patients diagnosed with lung squamous cell carcinoma (cancer). Squamous cell lung cancer is a form of non-small cell lung cancer. These cancers usually begin in the bronchial tubes (large airways) in the central part of the lungs. Squamous cells are thin, flat cells that look like fish scales. They are found in the tissue that forms the surface of the lining of the respiratory tract.

Eighty percent of all lung cancers are non-small cell lung cancers, and of these, about 30 percent are squamous cell. It’s a disease commonly found in smokers. Squamous cell carcinoma has a high rate of spreading to other parts of the body. 

There is an abnormality in the protein called FGFR that has been found to drive the growth and spread of lung cancer and other kinds of cancers, such as bladder and breast cancer. Up to one-fifth of patients with squamous cell lung cancers carry this abnormal FGFR protein. There are multiple drugs being developed that can target this FGFR protein abnormality.

At RPCI, we are one of the few centers undertaking a clinical trial of a drug that targets FGFR for patients with squamous cell lung cancer. There are multiple other treatments being developed specifically against each unique protein abnormality that spurs the growth and spread of each subgroup of lung cancer. We are at the cusp of creating an innovative personalized therapy for this all-too-common lung cancer.

We envision in the coming years that these advancements will also benefit other lung cancer patients.

It is encouraging news for us as doctors and scientists, but especially for our patients. And it’s one more way we are finding ways to change the once-inevitable course of cancer. Cancer can’t win—and will not win—due to efforts like these happening across Roswell Park.