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Biomarkers and Personalized Medicine
Sharing relevant articles on advancements in personalized medicine
Curated by Brian Shields
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Blood Protein Test Can Identify Lung Cancer Patients Likely to Benefit from Targeted Therapy

A recent phase III clinical trial confirmed that the VeriStrat test can predict which lung cancer patients are likely to fare better when treated with EGFR inhibitors like erlotinib (Tarceva). Patients with advanced non-small cell lung cancer (NSCLC) were tested using VeriStrat before beginning Tarceva treatment. Those who had a VeriStrat result of “Good” experienced longer times without cancer growth and longer overall survival on Tarceva compared to those with a “Bad” result. VeriStrat results may help doctors distinguish patients who should be given EGFR inhibitors from those for whom the benefits would not outweigh the side effects, and who would be better served by other treatments. VeriStrat does not test for mutations in the EGFR gene. Instead, the test assesses the pattern of several proteins in the blood to pinpoint patients likely to respond to EGFR inhibitors, including patients who may not have an EGFR mutation.


Via Cancer Commons
Brian Shields's insight:

Some interesting data out of ASCO using protien signatures in the blood to help develop personalized medicine for lung cancer patients.  Article excerpt follows:

The results from the Phase 3 trial announced today, shows it can make that difference, in a prospective study, which means that patients got the Biodesix test, were treated based on its recommendation, and followed over time to see if they ended up any better off. Passing that kind of rigorous study, should greatly expands the commercial potential for VeriStrat, Brunel said.

“VeriStrat has been commercially available for several years, but adoption has been limited…. This could lead to widespread adoption,” Brunel said.

According to the American Cancer Society, about 220,000 Americans per year are diagnosed with lung cancer, and about 85-90 percent have non-small cell lung cancer.

Biodesix will now build a national sales team and develop its marketing to try to capitalize on VeriStrat’s commercial potential, which could improve as the federal government is expected to reach a decision soon about whether it will be covered by Medicare.

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Cancer Commons's curator insight, June 6, 2013 5:38 AM

Xconomy | June 3, 2013

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Dr. Kris on Dacomitinib in EGFR-Positive Lung Cancer

Dr. Kris on Dacomitinib in EGFR-Positive Lung Cancer | Biomarkers and Personalized Medicine | Scoop.it
Mark G. Kris, MD, from Memorial Sloan-Kettering Cancer Center, discusses the administration of dacomitinib for patient with EGFR-positive lung cancer.
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Very Positive data for patients in need of new treatments due to TKI resistance

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Influence of Chemotherapy on EGFR Mutation Status Among Patients With Non–Small-Cell Lung Cancer

Excerpt from abstract:"Conclusion Our results suggest that chemotherapy may reduce EGFR mutation frequency in patients with NSCLC, likely the result of a preferential response of subclones with EGFR mutations in tumors with heterogeneous tumor cell populations."

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Efficacy of EGFR tyrosine kinase inhibitors for non-adenocarcinoma NSCLC patients with EGFR mutaiton

Efficacy of EGFR tyrosine kinase inhibitors for non-adenocarcinoma NSCLC patients with EGFR mutation.
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Retreatment with Targeted Therapy after Acquired Resistance ...

Retreatment with Targeted Therapy after Acquired Resistance ... | Biomarkers and Personalized Medicine | Scoop.it
Certainly, cases of responses with an EGFR TKI after someone has progressed, then been off of one for a while have emerged in the last few years, though there have not been real studies to address this question.
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#ASCO12 Data Digest: Combating Resistance in Lung Cancer | The Haystack

Great Post by Sally Church reviewing the current data from ASCO on Combating resistance to therapies in the treatment of Lung Cancer 

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ASCO 2012: Finally, Progress Reported With Targeted Treatments for Lung Cancer | BioWorld

ASCO 2012: Finally, Progress Reported With Targeted Treatments for Lung Cancer | BioWorld | Biomarkers and Personalized Medicine | Scoop.it

Exciting news out of ASCO for the treatment of NSCLC.  New targeted therapy afatinib demonstrates effectiveness in 1st line therapy while a Phase I trial shows promising results for immunotherapy.

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Clarient Gains Rights to ALK Cancer Biomarker from Insight Genetics - Genetic Engineering News

Clarient Gains Rights to ALK Cancer Biomarker from Insight Genetics - Genetic Engineering News | Biomarkers and Personalized Medicine | Scoop.it

Clarient Gains Rights to ALK Cancer Biomarker from Insight Genetics. Clarient Diagnostic Services entered a worldwide licensing agreement for intellectual property from Insight Genetics, granting Clarient rights to develop a...

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Optimization of patient selection for EGFR-TKIs in advanced non-small cell lung cancer by combined analysis of KRAS, PIK3CA, MET, and non-sensitizing EGFR mutations

Optimization of patient selection for EGFR-TKIs in advanced non-small cell lung cancer by combined analysis of KRAS, PIK3CA, MET, and non-sensitizing EGFR mutations | Biomarkers and Personalized Medicine | Scoop.it

Conclusions

When KRAS, PIK3CA, MET, and non-sensitizing EGFR mutations are concomitant, up to 96.0% of NSCLC patients unlikely to respond to TKIs can be identified, and they represented independent negative prognostic factors. Comprehensive molecular dissection of EGFR signaling pathways should be considered to select advanced NSCLC patients for TKIs therapies

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Correlations between the percentage of tumor cells showing an ALK (anaplastic lymphoma kinase) gene rearrangement, ALK signal copy number, and response to crizotinib therapy in ALK fluorescence in ...

Correlations between the percentage of tumor cells showing an ALK (anaplastic lymphoma kinase) gene rearrangement, ALK signal copy number, and response to crizotinib therapy in ALK fluorescence in ... | Biomarkers and Personalized Medicine | Scoop.it

CONCLUSIONS:

The strong association between increased copy number of key ALK signals and percentage of positive cells suggests that the <100% rate of cellular positivity in ALK+ tumors is due to technical factors, not biological factors. In ALK+ tumors, neither the percentage of positive cells nor signal copy number appear to be informative variables for predicting benefit from ALK inhibition. The inverse relationship between fused and isolated red copy number suggests ALK+ may be a distinct “near-diploid” subtype of NSCLC that develops before significant chromosomal aneusomy occurs. Cancer 2012;. © 2012 American Cancer Society.

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New research confirms need for lung cancer testing | University of Colorado Denver

New research confirms need for lung cancer testing | University of Colorado Denver | Biomarkers and Personalized Medicine | Scoop.it

Different kinds of lung cancer behave in different ways, suggesting they are fundamentally different diseases. According to a University of Colorado Cancer Center study published in Cancer, the official journal of the American Cancer Society, different subgroups of non-small cell lung cancer (NSCLC) show distinct patterns of spread in the body...

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Ventana to Collaborate with Pfizer and CST on Companion Diagnostic to Identify Lung Cancer Patients with ALK Gene Rearrangements - Drugs.com MedNews

Ventana to Collaborate with Pfizer and CST on Companion Diagnostic to Identify Lung Cancer Patients with ALK Gene Rearrangements - Drugs.com MedNews | Biomarkers and Personalized Medicine | Scoop.it
Collaboration a significant step in the war against non-small cell lung cancer (NSCLC) TUCSON, Jan. 10, 2012 Ventana Medical Systems, Inc.
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GRACE :: Lung Cancer» Blog Archive » HER2 Mutations: Small ...

GRACE :: Lung Cancer» Blog Archive » HER2 Mutations: Small ... | Biomarkers and Personalized Medicine | Scoop.it
Dr. Pinder previously covered the potentially clinically relevant target of HER2/neu (HER2) mutations for lung cancer. Specifically, she noted that Herceptin (trastuzumab), an antibody against the HER2 receptor (in the same ...
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Pfizer's Xalkori And The Progress In Lung Cancer Drugs

Pfizer's Xalkori And The Progress In Lung Cancer Drugs | Biomarkers and Personalized Medicine | Scoop.it
Lung cancer is a tricky disease and there is a graveyard littered with lung cancer drugs that failed in clinical trial.Targeted approaches like Xalkori from Pfizer (PFE) and Tarceva from Roche (RHHBY.OB) work for small segmen...
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Very good insight on the current targeted options available for lung cancer patients and the promising products in development such as Dacomitinib and Reolysin.  The article notes that the molecular testing rate in Lung Cancer is now 60%, a growth from 10% at the launch of Xalkori.

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Does Molecular Heterogeneity Explain a “Mixed Response” on Follow-UP Scans. Insights from EGFR Mutation Testing

Does Molecular Heterogeneity Explain a “Mixed Response” on Follow-UP Scans. Insights from EGFR Mutation Testing | Biomarkers and Personalized Medicine | Scoop.it
An important question about cancer imaging that we hear a lot is about a so-called “mixed response” to systemic therapy, in which a scan shows some areas of the cancer shrinking as others grow, or new lesions appear.
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The ASCO Post

The ASCO Post | Biomarkers and Personalized Medicine | Scoop.it

RT @ASCOPost: First-line #Afatinib Superior to Standard #Chemotherapy in Advanced EGFR-mutated Non–Small Cell #LungCancer http://t.co/MROS5MpX #NSCLC...

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Timing of Epidermal Growth Factor Receptor Tyro... [J Clin Oncol. 2012] - PubMed - NCBI

Journal of Clinical Oncology case report of a 45 year old women with Stage IV NSCLC with EGFRmut

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Response Genetics, Inc. to Offer Enhanced ALK Testing Program for Metastatic ... - MarketWatch (press release)

Response Genetics, Inc. to Offer Enhanced ALK Testing Program for Metastatic ... - MarketWatch (press release) | Biomarkers and Personalized Medicine | Scoop.it

Response Genetics, Inc. to Offer Enhanced ALK Testing Program for Metastatic Lung Cancer

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Molecular Profiling for NSCLC

Very good patient-focused site by Pfizer on molecular profiling for NSCLC.

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ASCO: Chemo Beats Targeted Drug in NSCLC - MedPage Today

ASCO: Chemo Beats Targeted Drug in NSCLC - MedPage Today | Biomarkers and Personalized Medicine | Scoop.it

"KRAS-mutant and wild-type tumors appeared to do better with docetaxel, Marina Garassino, MD, reported here at the American Society of Clinical Oncology (ASCO) meeting."

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Study identified source of crizotinib resistance in ALK-positive lung cancer | HemOncToday

Study identified source of crizotinib resistance in ALK-positive lung cancer | HemOncToday | Biomarkers and Personalized Medicine | Scoop.it

"Somatic kinase domain mutations, gene fusion and the emergence of separate oncogenic drivers are factors responsible for the observed crizotinib resistance ..."

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Novel gene mutations associated with bile duct cancer - Massachusetts General Hospital, Boston, MA

Novel gene mutations associated with bile duct cancer  - Massachusetts General Hospital, Boston, MA | Biomarkers and Personalized Medicine | Scoop.it
Investigators at the MGH Cancer Center have identified a new genetic signature associated with bile duct cancer, a usually deadly tumor for which effective treatment currently is limited.
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Oncogene status predicts patterns of metastatic spread in treatment-naive nonsmall cell lung cancer - Doebele - 2012 - Cancer - Wiley Online Library

Oncogene status predicts patterns of metastatic spread in treatment-naive nonsmall cell lung cancer - Doebele - 2012 - Cancer - Wiley Online Library | Biomarkers and Personalized Medicine | Scoop.it

Patterns of metastatic spread were evaluated in patients with untreated nonsmall cell lung cancer following subclassification by ALK, EGFR, and KRAS. ALK gene rearrangements were associated with metastases to the pericardium, pleura, and liver...

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New Study Helps Predict Which Lung Cancer Drugs are Most Likely to Work - insciences

New Study Helps Predict Which Lung Cancer Drugs are Most Likely to Work - insciences | Biomarkers and Personalized Medicine | Scoop.it

"Researchers at Johns Hopkins have shown that DNA changes in a gene that drives the growth of a form of lung cancer can make the cancer’s cells resistant to cancer drugs. The findings show that some classes of drugs won’t work, and certain types of so-called kinase inhibitors like erlotinib—may be the most effective at treating non-small cell lung cancers with those DNA changes. Some kinase inhibitors block a protein known as EGFR from directing cells to multiply.

In their paper published online November 20 in Nature Structural & Molecular Biology, the researchers describe the molecular details of how some cancer drugs work..."

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Adaptive Clinical Trial Design: Has Its Time Come?

The Battle Trial is one of the most forward thinking trials in recent hisory.  Although the results of the trial were very positive, it was also the trial design which really puts Oncology in a new era.  Rather than structure trials for minimal PFS or survival benefits over a large population, this trial was structured to determine the true benefits of biomarker screening prior to using a particular agent...This trial also proved that tissue ollection can be achieved in a complex trial with multiple drugs in NSCLC.

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