New Molecular Targeted Therapies Integrated with Radiation Therapy in Lung Cancer

Recent research from Madrid, Spain, reveals that non-small-cell lung cancer (NSCLC) accounts for approximately 80%-85% of all cases of lung cancer, with stage III disease making up around 40% of all cases. For patients with unresectable stage III NSCLC, the treatment typically involves a combination of platinum-based chemotherapy and thoracic radiation. Researchers are now exploring the integration of new molecular targeted therapies with radiation therapy to improve treatment outcomes.

Key Takeaways:

NSCLC accounts for approximately 80%-85% of all cases of lung cancer, with stage III disease making up around 40% of all cases.
The treatment for unresectable stage III NSCLC is typically a combination of platinum-based chemotherapy and thoracic radiation.
New targeted agents, such as cetuximab and gefitinib, are being investigated for possible integration into the combined therapy.
Radiation activates the epidermal growth factor receptor (EGFR) pathway, leading to radio-resistance.
Several preclinical models have shown synergistic activity when cetuximab is combined with radiation therapy.
Phase II trials have evaluated the safety and efficacy of synchronous cetuximab and radiation therapy with promising results.
Gefitinib has a radiosensitizing effect on cell lines and has been investigated in combination with radiation therapy for unresectable stage III NSCLC, with disappointing results observed in the maintenance treatment with gefitinib after chemoradiation therapy.
Erlotinib has been tested in a phase I trial with chemoradiation therapy, and trials combining erlotinib and bevacizumab with thoracic radiation are ongoing.
New strategies must be developed for the integration of this triple-combination treatment.
Aurora kinase inhibitors with radiation therapy seem to have an additive effect in preclinical models in NSCLC and mesothelioma.

Statistics:

NSCLC accounts for approximately 80%-85% of all cases of lung cancer.
Stage III disease makes up around 40% of all cases of NSCLC.
Approximately 40% of patients with unresectable stage III NSCLC are treated with a combination of platinum-based chemotherapy and thoracic radiation.

Sources:

Provencio, M. et al. "New molecular targeted therapies integrated with radiation therapy in lung cancer." Clinical Lung Cancer, 2010;11(2):91-7.
University Hospital, Department of Medical Oncology
Lung Cancer Therapy