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Lung cancer: ICAM, a new predictor for treatment response and survival

Researchers at the Ireland Cancer Center of University Hospitals of Cleveland have found a promising, novel biomarker that may be used to predict the survival of patients with advanced lung cancer and their response to treatment.

Afshin Dowlati at the Ireland Cancer Center found that patients with a low level of the biomarker ICAM had a better chance of survival and an increased response to chemotherapy.
Dowlati analyzed data from a major national study that found the monoclonal antibody Bevacizumab ( Avastin ), in addition to standard therapy, was more effective than standard treatment alone for patients with advanced, non-squamous non-small cell lung cancer.

The analysis indicated that patients with low levels of ICAM ( intercellular adhesion molecule –1 ), had a higher response rate to treatment ( 29% versus 13% ) than patients with high ICAM levels. Patients with low ICAM levels also had a significantly better overall survival rate.

" We believe this research confirms a significant new prognostic marker in lung cancer," says Dowlati. " Previously, it has been a challenge to identify those patients that will respond best to treatment and what their outcomes will be. This biomarker appears to serve as a much better predictor than gender, patients' overall health and sites of metastases." These findings confirm a pilot study performed three years ago at Ireland Cancer Center by Dowlati, Scot Remick and Keith McCrae.

Data was analyzed from a phase III study, conducted by the Eastern Cooperative Oncology Group ( ECOG ), which involved 878 patients nationwide who were randomized to standard chemotherapy - Paclitaxel and Carboplatin - with and without Bevacizumab.
Patients who received Bevacizumab lived 2.5 months longer and had a 24.8% shrinkage in their tumors versus 9.4% shrinkage in patients who had chemotherapy alone.
Bevacizumab is an anti-angiogenesis inhibitor designed to prevent the formation of new blood vessels to the tumor.

" This represents a major step forward in treating patients with advanced lung cancer," says Stanton Gerson, director of the Ireland Cancer Center and the Case Comprehensive Cancer Center. " This biomarker may help clinicians identify patients who are candidates for treatment and who will benefit from it. This finding is likely to be useful in other cancers as well."

Lung cancer is the second most commonly diagnosed cancer and is the leading cause of cancer-related death in both men and women in this country. An estimated 163,510 deaths from lung cancer occurred in 2005 in the United States, accounting for about 29 percent of all cancer-related deaths in the nation.

Source: University Hospitals of Cleveland, 2006