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Duo of drugs pair up to battle lung cancer 

 


By Shawn Le


Could a pain-relieving drug help fight lung cancer? City of Hope scientists are trying to find out.

Lung cancer is one of the most difficult cancers to treat successfully. That’s partly because the cancer can become resistant to drugs.

Photo of Karen ReckampKaren Reckamp (Photo ©2007 Philip Channing)

But researchers may have found a way to make certain lung tumors more vulnerable to a type of chemotherapy — by pairing it with a prescription analgesic.

As City of Hope oncologist Karen Reckamp, M.D., M.S., explains it, one of today’s standard treatments for non-small cell lung cancer targets a protein in tumor cells called epidermal growth factor receptor (EGFR).

EGFR spurs tumor growth and development. Some modern drugs, called EGFR inhibitors, work by countering EGFR. Unfortunately, the standard EGFR inhibitor used against lung cancer only works for about 10 percent of patients. Most tumors either immediately overcome the drug or become resistant over time, said Reckamp, assistant professor in the Department of Medical Oncology & Therapeutics Research.

But results from early clinical trials of a new strategy are promising. The method combines the EGFR inhibitor with another drug called a COX-2 inhibitor. The combination may be more effective than the EGFR inhibitor alone.

COX-2 inhibitors suppress the COX-2 enzyme, which is highly active in lung tumors. Studies have linked high levels of the enzyme to tumor growth. Suppressing COX-2 might directly influence tumor development, and it also could make EGFR-inhibiting drugs more effective, researchers believe.

According to Reckamp, who leads trials on the strategy at City of Hope, patients on the trial whose advanced lung cancer had resisted EGFR inhibitors earlier actually saw their cancers stabilize. That means the cancers slowed or stopped growing and did not spread. 

The first randomized study enrolled 20 patients with advanced non-small cell lung cancer. Results encouraged the researchers to take the strategy further.

“We are now conducting a phase II trial with an existing COX-2 inhibitor, celecoxib, originally approved to treat arthritis pain, which we can potentially repurpose to make cancer therapies more effective,” said Reckamp. The trial pairs the drug with the EGFR inhibitor called erlotinib.

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