Lung cancer

31 October 2013

Gene testing may boost lung cancer survival

German researchers say patients with lung cancer mutations who receive personalised therepies seem to survive longer than others.

Chances of surviving lung cancer for a longer period of time increase when treatment is personalised based on the genetics of the cancer, German researchers report.

Knowing the tumour's genetic signature can help doctors spot differences in cancer cells that may lead to a more accurate diagnosis and better-targeted therapy, the researchers explained.

"Gene classification and diagnosis has a profound impact on a patients' survival," said study co-author Dr Reinhard Buttner, a professor of pathology at the Cologne University Hospital.

"Our data were collected from approximately 5 100 lung cancer patients and show that genotyping of lung cancer doubles overall survival in patients with two specific mutations called EGFR-mutated and ALK-translocated," Buttner said.

Patients with those mutations who received personalised therapies had survival rates from somewhere between 12 months and 21 months.

Genetically different

The report was published in the journal Science Translational Medicine.

The researchers found that although some lung cancer cells look the same under the microscope, they may actually be quite different genetically.

"Systematic profiling of gene mutations in lung cancer allows precise classification and diagnostics and predicts the efficacy of targeted and personalised therapies. Every lung cancer should be analysed for mutations to find the best therapy," Buttner said.

Surprisingly, looking at two common types of lung cancer such as small-cell and large-cell from a genetic perspective actually ended up eliminating large-cell lung cancer as a distinct category, he said.

In addition, genotyping identifies many cancer mutations that might be targeted with therapies in new clinical trials, Buttner said.

The bottom line is that knowing the genetics of a cancer can help personalise treatment and improve survival.

"Gene characterisation of lung cancers and probably other cancers allow selective therapies, which immediately improve survival," he said.

"This analysis of tumours in lung cancer, at the end of the day, leads to a better prognosis," said study co-author Dr Thomas Zander, a research fellow in the lung cancer group at University Hospital Cologne.

"That's because a patient can get personalised treatment."

Genetic analysis

"I am convinced that this will be the future of cancer treatment, not only for lung cancer, but for nearly every type of cancer," Zander said.

A US expert not involved with the study agreed about the importance of genetic analysis and personalised treatment.

"Genetic analysis is going to become an intrinsic part of cancer treatment. There is a lot of promise that this is the best way of treating patients going forward," said William Phelps, scientific programme director at the American Cancer Society.

The other part of personalised treatment is the development of new drugs that target particular gene mutations, Phelps said.

"There are limited drugs available now. You are going to see more drugs available, so genetic testing will be that much more valuable going forward as more targeted therapies become available," he said.

Phelps noted that such analysis is being performed, but on a limited scale.

"Not everyone has the capability to do this. You not only have to be able to do the genetic analysis, but you also have to be able to tell which mutations are meaningful and which are not," he said.

But the process is starting and being tested at the major cancer centres, Phelps added.

"I think this is where we are evolving to. It's not widely available yet, but we are trying to make it more widely available," he said.

As in the United States, access to gene typing of cancer in Germany is limited to major cancer centres.

"One of the things we want to do is increase the visibility of gene typing so that more patients and more doctors are aware of it," said Zander.

More information

For more about lung cancer, visit the American Cancer Society.


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