Continued advances in treatment options for patients with lung cancer are fueling patients’ hopes for life extensions in the face of the country’s deadliest cancer. In honor of this year’s upcoming World Lung Cancer Day, medical oncologist Hamid Mirshahidi, MD, of Loma Linda University Cancer Center, and patient Maribel Padilla spread the word about a kind of promising treatment option available to people with lung cancer.
While chemotherapy tends to think of the conventional cancer treatment route first, a slew of targeted therapies are constantly emerging from the Research and clinical trials may outperform chemotherapy in groups of patients with specific genetic mutations, Mirshahidi says.
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Such was the case for 55-year-old Maribel Padilla, who, before reaching Loma Linda University Health in 2011, was told she had up to a year to live with stage four. lung cancer that spread to her brain. After undergoing brain surgery at the original facility, Padilla transferred to LLU to work with the Cancer Center team and participate in three clinical trials. Since then, she has celebrated a decade of her life.
Our mindset was to give it a shot because we thought our mom had less than a year to live and we had nothing to lose. Gabriela Castillo
To determine whether Padilla would benefit from targeted therapy, LLU cancer experts performed a tissue biopsy and analyzed her DNA. Sure enough, Padilla possessed a mutation in DNA called anaplastic lymphoma kinase (ALK), which made her one of approximately 25% of lung cancer patients with an oncology “driver mutation” and qualified her for enrollment in some clinical trialssaid Mirshahidi.
Of those 25%, Padilla was specifically among the 5% of patients with ALK — a DNA mutation in lung cells that occurs when two genes fuse together, causing lung cells to make too many copies of themselves that are cancerous and can spread throughout the body.
Padilla and her daughters, Gabriela and Karla Castillo, learned about the clinical trials and eventually took the plunge to enroll. “Our mindset was to give it a shot because we thought our mom had less than a year to live and we had nothing to lose,” Gabriela said.
Padilla took part in a trial of the drug Crizatinib for the first time and experienced minimal side effects. But as lung cancer mutates and moves through the body, it can become resistant to one drug and weak to another. Aware of this phenomenon, LLU Cancer Center’s weekly multidisciplinary team quickly and repeatedly tests for patient mutations and tailors treatment to a newly targeted therapy drug.
After about a year on the first drug, Padilla’s cancer spread to her brain a second time, and her healthcare team promptly enrolled her in a new clinical trial for a drug called Ceratinib. She continued this treatment regimen for years to control the cancer and again experienced minimal side effects compared to what chemotherapy usually produces.
Ms. Padilla was able to benefit from and prove that those targeted therapy drugs for lung cancer patients with the same mutations are much more beneficial than chemotherapy would have been.dr. Hamid Mirshahidic
Most recently, Padilla started Lorlatinib through compassionate use, which happens when a pharmaceutical company gives a clinical center the ability to give their patients a non-FDA-approved drug. Since Padilla completed the clinical trials and began compassionate use, all three targeted therapies have been approved by the FDA.
To gain FDA approval, targeted therapies must prove themselves more effective than conventional chemotherapy for a specific group of patients, Mirshahidi said. After a targeted therapy is approved, a new, more potent drug usually requires a new clinical trial, and so on.
“She has been in treatment for about eight years now with no evidence of recurrence and has never tried conventional IV chemotherapy at LLU,” he said. “Mrs. Padilla was able to benefit from and prove that those targeted therapy drugs for lung cancer patients with the same mutations are much more beneficial than chemotherapy would have been.
Since starting targeted therapy for her lung cancer, Padilla says she felt grateful to live the past 10 years, during which she met her five newborn grandchildren and cemented her pre-existing bonds with her other grandchildren.
Meanwhile, advances in targeted therapies continue at full speed as Loma Linda University Heath continues to improve and hone life-changing treatment plans to optimize the health journeys of lung cancer patients.
At Loma Linda University Cancer Center, physicians are committed to providing patients with compassionate, comprehensive care that gives them the best chance of facing and overcoming cancer. For more information about lung cancer care at the Cancer Center, visit: lluh.org/cancer-center/cancer-programs/lung-cancer-care.