Skip to Navigation Skip to Search Skip to Content
Search All Centers

Expanding New Drugs and Increasing Response Rates for More Lung Cancer Patients

Read Transcript Download/Print Transcript
View next

Published on April 14, 2016

What new identifying factors are making a difference for lung cancer patients?  Patient Power founder Andrew Schorr interviewed Dr. Rebecca Heist, hematologist/oncologist at Massachusetts General Hospital, asking her opinion on the expanding armamentarium.  Dr. Heist discusses multiple dynamics including targeted therapies, inhibitors, newly discovered targets, immunotherapies, and resistance therapies aimed at mutations.

Featuring

Partners

LUNGevity Foundation The University of Texas MD Anderson Cancer Center

Sponsors

Patient Empowerment Network The University of Texas MD Anderson Cancer Center

Transcript | Expanding New Drugs and Increasing Response Rates for More Lung Cancer Patients

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.         

Andrew Schorr:

Hello and welcome to Patient Power.  I'm Andrew Schorr.  Well, the detective work in lung cancer continues to go on so that we can identify more ways to help more patients.  And joining us now is one of the detectives, if you will, Dr. Rebecca Heist from Mass General in Boston and Harvard Medical School.  Thank you for being with us.  

Dr. Heist:

Thank you.  Thank you.  It's a pleasure to be here.  

Andrew Schorr:

So let's talk about detective work.  What are you identifying about lung cancer that you're excited about that could make more of a difference for more patients?  

Dr. Heist:

I think there have been many things recently that have been identified that make a huge difference for patients.  First, just thinking about targeted therapies, we know that lung cancers have specific targets that certain drugs can hit very effectively, so we're very excited about the work being done in EGFR, ALK and ROS.  We know there are specific inhibitors that can really help people with those changes, and recently there have been several new drugs approved in those settings. 

So there is work in the resistance setting as well that helps people even after their first or second EGFR or ALK inhibitor, so that's very exciting.  There are other new targets that are being discovered every year, essentially.  Recently, we've been very excited about something called MET exon 14 skipping, which is a new target.  It seems to happen in about 5 percent of lung cancers, and we think the MET inhibitors will have good activity here, so this is a great area of clinical trials right now. 

So the targeted world is very, very active. 

And I think the other encouraging thing is that there is real progress being made in kind of the non-targeted world, so to speak.  Immunotherapy has made huge progress in lung cancer, which was a surprise several years ago but really has kind of come into its own, so there are many new therapies that are available for patients.  

Andrew Schorr:

Let's talk about that for a minute.  So the hope is that the immune system can be sort of retrained, if you will, the brakes can go off it to fight the cancer that it didn't recognize the first time, wherever it may be.  And there have been news reports even recently about what we've seen in some other areas.  I guess it's sort of the CAR T cells and things like that but making a vaccine for you. 

Dr. Heist:

Yep. 

Andrew Schorr:

Expensive, customized, that's sort of leading edge of research. But if we look at this whole continuum of immunotherapy, is that where we're headed? 

Dr. Heist:

I think there's a whole lot of work to be done there, and I think it's a whole field that's going to help many, many people.  We know right now that PD-1 inhibitors in lung cancer have activity.  It helps some people a great, great deal.  And one of the exciting things about immunotherapy is that the response seems to be durable in a way that we haven't seen with so many other agents. 

But it doesn't help everybody, and a lot of the work is really trying to figure out how can we get it to help more people and raise that response rate from 20 percent to 40 percent, 60 percent, everybody.  And many of the trials now are focused on that, trying to build on what has been done with PD-1 and PDL-1 inhibition and expand that potential for immunotherapy to everybody. 

Andrew Schorr:

Going back to where we are today, you used the word a minute ago "resistance," so where the cancer kind of finds its way around a drug that you've been using that's been working for a while.  So are you finding now that you're having more agents so that if somebody becomes resistant to one, there's something else? 

Dr. Heist:

Yes, absolutely.  So to take the example of EGFR, we had EGFR inhibitors that were the first?line inhibitors. And then we knew for a long time actually that when people became resistant, about half the time they developed a secondary mutation, something called T790M in EGFR.  And recently there have been new drugs that fight this that can actually produce responses in people who develop T790M. 

And so the more we learn about resistance and why cancers become resistant, the more we're able to develop drugs that actually fight that resistance.  The same goes for ALK as well. So I think an important thing is really trying at the time a tumor starts to grow to figure out why is it doing that and what's the mechanism so that we can try and hit that mechanism.  

Andrew Schorr:

So it sounds like there's a partnership we need to have between the patient and the doctor… 

Dr. Heist:

Oh, absolutely. 

Andrew Schorr:

…communicating what's going on, having the right diagnostic tests so you have a clear picture of where they are or if something is changing so that if there are either approved or investigational agents, that can be brought to bear for them. 

Dr. Heist:

Absolutely.  You know, the patient is part of the detective work.  They are the detectives along with us, and we really need the information from them really to know what's going on and how best to treat them.                    

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

View next