In an interview with CURE®, Dr. Jorge Gomez discussed how recent developments in the assessment of biomarkers within the small cell lung cancer and non-small cell lung cancer space have led to approvals of new and expanded therapies.
There have recently been several drug approvals from the Food and Drug Administration (FDA) in the lung cancer space, and, according to Dr. Jorge Gomez, that is in large part due to the success of recent studies over the years in both non-small cell lung cancer and small cell lung cancer.
Gomez, medical director of the Thoracic Oncology Program at Mount Sinai Hospital in New York City, and speaker for the American Lung Association, spoke with CURE® on how the focus on finding biomarkers in these spaces has led to more treatment options for patients with lung cancer.
The development of biomarkers has been going on for a long time. In the past, we used to use very simple biomarkers like chemicals present in the blood. There is a marker called CEA, which was a biomarker that was popular in the '70s, '80s and '90s as a marker for lung cancer, for kind of tracking lung cancer to see whether it was responding or whether patients had a recurrence of their disease. The biomarkers that we use now are much more sophisticated.
The most important biomarkers in lung cancer are really what we call activating mutations, they're changes or mutations in the tumor DNA that tell us that that cancer is much more likely to respond to specific drugs which we call targeted therapies. And so, many of the most recent approvals are really for those patients, for patients with activating mutations, a specific mutation, who will respond or very likely to respond to that drug. But each of those biomarkers covers only a small population of patients. The one that is the best covers about 20% of lung cancer patients. Some of the other biomarkers cover 1 or 2% of patients with lung cancer.
The biomarkers for immunotherapy are less exact, they're less specific. And there are many different biomarkers that are currently being studied. Some with more success, some with less success. I think in the end, what we will probably do is look at a multiple different biomarker, maybe a panel of biomarkers that can give us a much better sense of where to use these drugs and how to use these drugs.
If nobody succeeds, then things kind of peter out. There is a lung cancer called small cell lung cancer, which is a kind of a more aggressive type of lung cancer. It's a tobacco-related malignancy, which tends to respond very well to chemotherapy but responds for a very short time and so … the survival of those patients is shorter than the regular non-small cell type of lung cancer.
And for many, many years, all of the clinical trials done in small cell lung cancer had been negative and negative and negative (and) that kind of pushes people away from doing research in that area because they're concerned that all of those efforts will lead nowhere.