PET Scan May Offer Non-Invasive Method to Guide Physicians to Personalized Treatment Options for Mesothelioma Patients
In April, the American Society of Clinical Oncology (ASCO) released a provisional clinical opinion (PCO) stating that by first determining whether advanced non-small-cell lung cancer (NSCLC) patients, and likely mesothelioma patients, have mutations of the epidermal growth factor receptor (EGFR) gene, oncologists can select a chemotherapy drug that may be better suited to treat the disease. Now researchers from VU University Medical Center in Amsterdam, the Netherlands, have found that through a non-invasive PET scan they can identify those genes, thus making way for personalized treatment for lung cancer and mesothelioma patients.
Principal investigator Dr. Idris Bahce, of VU University, said in a presentation at the 14th World Conference on Lung Cancer in Amsterdam, “As more and more therapeutic agents are becoming available for non-small cell lung cancer therapy, selecting the best drug for each individual patient becomes increasingly challenging. Predictive markers may offer guidance in personalizing therapy.”
Both ASCO and Bahce found that patients with an EGFR expression may benefit from treatment with tyrosine kinase inhibitors (TKIs). EGFR is a protein found on the surface of cells which causes the cells to divide. It is found at abnormally high levels on the surface of many types of cancer cells, including pleural mesothelioma, an asbestos-related pulmonary cancer. TKIs are cancer growth blockers that inhibit or block the growth factors that trigger the cancer cells to grow and divide, thus controlling the metastasis of the cancer.
In the VU study, NSCLC patients underwent PET scans using erlotinib (Tarceva®, Genentech Inc), a TKI that is often used to treat NSCLC in patients who have already been treated with at least one other chemotherapy medication, and have not improved.
Those patients with an activating EGFR mutation “also had an increased tracer uptake and were more sensitive to treatment with erlotinib as compared to those who did not have this mutation,” Dr. Bahce said. Bachce added, “This is an important finding, as it indicates that this new imaging PET technique may be a non-invasive predictive marker that identifies NSCLC patients who benefit from treatment with TKIs.”
This study is critical for pleural mesothelioma, a cancer of the lining of the lungs, and lung cancer patients in that oncologists now have a non-invasive, improved method to find a specific marker (EGFR) with a known, beneficial treatment (TKIs) allowing them to personalize the patients’ therapy. Care targeted to a patient’s unique genetic makeup optimizes the potential for success of the treatment and offers treatment options that may not otherwise have been considered.
