A study of genomic data in patients with advanced small-cell lung cancer, led by researchers at The Ohio State University Comprehensive Cancer Center, has unveiled new insight into the patterns of treatment resistance, which could lead to new precision medicine treatments.
The researchers stated that advanced small cell lung cancer progresses quickly and is usually fatal. It accounts for 15 percent of lung cancer cases worldwide. Initial chemotherapy treatments often work well to tackle the disease, but it typically recurs in a lethal, treatment-resistant form.
Principal Investigator Sameek Roychowdhury, MD, PhD, a medical oncologist and member of the OSUCCC – James Translational Therapeutics Research Program, said, “Advanced SCLC often does not respond as well to immune therapies that are effective in other types of lung cancer, and the reasons for this are poorly understood.
“Our findings suggest that the causes of treatment resistances in advanced small cell lung cancer may be subtype-specific. They also highlight the importance of tumor genomic studies to identify the most effective therapies for these patients and to support development of new therapies for this often-fatal disease.
“Understanding the specific drivers of a person’s cancer can help us identify potential alternative treatment options through clinical trials that would not have been possible otherwise.”
During the study, researchers analysed genomic data and total mRNA from tumour cells removed from five deceased patients with advanced small cell lung cancer, along with circulating tumour DNA.
The five patients consented to undergo a research autopsy soon after death to allow researchers to collect and evaluate many tumours.
The study’s key findings included the feasibility for rapid research autopsy to provide in-depth insights into resistant lung cancers. It also showed evidence that tumors have continued to grow after patients have received treatment.
The most common neuroendocrine small cell lung cancer subtypes showed high expression of the enzyme ARG2, a possible suppressor of immune responses. The study also supported the known association between Wnt pathway and chemoresistance in advanced SCLC.
“This facility is absolutely required to meet our clinicians’ immediate needs and expectations for molecular testing,” said Alexander “Craig” Mackinnon, Jr., MD, PhD, professor and director, Division of Genomic Diagnostics and Bioinformatics.
“This newly renovated lab is a bridge providing urgently needed space in the immediate near term. The next phase brings in additional partners, including Clinical Genetics and Pediatric Microbiology, as the labs integrate. The GDL will greatly increase the scale, scope, and efficiency of genetic testing at UAB.”
Read more about the study here.