New drug extends lung cancer survival 22 percent, UC Davis Cancer Center researchers report

Findings have broad implications for design of clinical trials for advanced non-small cell lung cancer (NSCLC)

Adding the new molecularly targeted agent bortezomib to a standard chemotherapy regimen of gemcitabine and carboplatin prolongs survival in patients with advanced non-small cell lung cancer, according to final results from a national phase II trial. Results of the Southwest Oncology Group (SWOG) study, led by UC Davis Cancer Center researchers, were reported this week at the annual meeting of the American Society of Clinical Oncology in Atlanta.

In the study, patients taking bortezomib plus gemcitabine and carboplatin had a median survival of 11 months, reported Angela Davies, an assistant professor of hematology and oncology at UC Davis Cancer Center and lead author of the study. In comparison, 9 months is the longest median survival seen in past SWOG trials of platinum-based chemotherapy treatments for advanced non-small cell lung cancer.

“These survival results are among the best ever reported in patients with NSCLC,” Davies said. “We look forward to further study of bortezomib in combination with chemotherapy as treatment for NSCLC in a larger, phase III trial.”

In the study, 114 newly diagnosed stage IV and selected stage IIIB patients received gemcitabine and carboplatin in combination with bortezomib. The median overall survival was 11 months; one-year survival was 46 percent, with a median five-month progression-free survival.

Other key findings:

• 66 percent of patients benefited from the therapy, experiencing tumor shrinkage or disease stabilization;

• The treatment was well tolerated; the most common side effects were neutropenia, a very low white-blood cell count; thrombocytopenia, a very low platelet count; and fatigue.

The study was supported by grants from the National Cancer Institute.

The Southwest Oncology Group is one of the largest National Cancer Institute-supported cancer clinical trial cooperative groups in the United States, with a network of more than 5,000 physician-researchers at nearly 550 institutions. Its lung committee is chaired by David R. Gandara, professor of hematology and oncology and director of the Clinical Research Program at UC Davis Cancer Center.

Lung cancer is the leading cause of cancer death among both men and women in the United States. According to the American Cancer Society, an estimated 174,470 people will be diagnosed with lung cancer this year, and 162,460 will die from it. Non-small cell lung cancer accounts for about 80 percent of lung cancer cases.

Bortezomib, sold under the trade name Velcade, is a small-molecule proteasome inhibitor originally approved as a treatment for multiple myeloma. It was developed by Millennium Pharmaceuticals, Inc., based in Cambridge, Mass.