Finding

On Cancer: Testing for Mutations Identified in Squamous Cell Lung Cancer Tumors Helps Personalize Treatment

By Media Staff  |  Thursday, May 17, 2012
Pictured: Paul Paik Medical oncologist Paul Paik

Screening lung cancer tumor samples for cancer-causing, or “driver,” genetic mutations can help physicians tailor patients’ treatments to target those specific mutations. While scientists have identified cancer-causing mutations for the majority of lung adenocarcinomas — the most common type of non-small cell lung cancer — and have developed drugs that can successfully address them, scientists have not yet identified targeted therapies for another type of non-small cell lung cancer known as squamous cell carcinoma.

Now, researchers from Memorial Sloan-Kettering Cancer Center have begun testing for three new genetic targets and found that together they occur in approximately 50 percent of patients with squamous cell carcinomas of the lung, which affects 40,000 Americans each year. Initial findings of the research will be presented on June 4 at the 2012 American Society of Clinical Oncology (ASCO) Annual Meeting.

“In the span of one year, we have gone from having essentially zero clinical trials of targeted therapies to offer our squamous cell lung cancer patients to being able to offer clinical trials of targeted therapies to upwards of 50 percent,” said Paul K. Paik, a medical oncologist on Memorial Sloan-Kettering’s Thoracic Oncology Service and lead investigator of the new molecular testing project known as the Squamous Cell Carcinoma of the Lung Mutation Analysis Program, or SQ-MAP.

Memorial Sloan-Kettering was one of the first centers to use this type of genetic testing for lung cancer patients and is currently one of the only centers testing for mutations in squamous cell carcinomas of the lung. Memorial Sloan-Kettering is also one of only a handful of centers in the world that conducts genetic testing of the tumor as a routine part of diagnosis and staging for patients with non-small cell lung cancer.

Genetic testing of lung adenocarcinomas is conducted as part of the Lung Cancer Mutation Analysis Project (LC-MAP), which began at Memorial Sloan-Kettering in January 2009. SQ-MAP, which began in October 2011, has already identified cancer-causing mutations in 50 percent of squamous cell lung carcinoma tumors tested. Enrollment is now open for two clinical trials of new targeted therapies for this type of cancer, and a third clinical trial is planned. 

Dr. Paik received a Conquer Cancer Foundation of ASCO Career Development Award and a Geoffrey Beene Grant Award for this project.

Comments

This was a very interesting article. My partner was diagnosed with lung cancer (squamous cell carcinoma and adenocarcinoma), which also spread to her liver. She has had chemo, radiation and the RFA procedure was done last week on her liver. We are still waiting on a biopsy result from caris on what chemo drugs to use to continue her battle with the lung. She is in a rest period now trying to get strong again to start chemo the first week of August. I have tried to get appointments at Sloan in Basking Ridge and the city before her next round of chemo, but have not been successful.
Joan, we will send you a private message on this topic.
Is there any further updates in regards to this article. We are located in Missouri and was wondering if this treatment was available near this region.
Dr. Paik has suggested that Washington University in St. Louis may have similar kinds of treatments for squamous cell lung cancer closer to where you live. If you would like to make an appointment with a Memorial Sloan-Kettering physician, please call our Physician Referral Service at 800-525-2225. Thanks for your comment!
My 87yr. old grandmother whos lives in Harrisburg, Pa. was diagnosed in August 2011 with Squamous carcinomas Lung Cancer. She has undergone Cyber Knife Radiation Treatment almost 9 months ago. Recently her tumor has grown larger and now her Oncologist attempted to begin Radio Abrascion Therapy. But they feel she might be worst off afterwards. Can you suggest another treatment or Cancer Center closer to her home that we can contact?
Thank you for reaching out. We would recommend that you review the list of National Cancer Institute-designated cancer centers here: http://www.cancer.gov/researchandfunding/extramural/cancercenters. If you would like to make an appointment at Memorial Sloan-Kettering, please contact our Physician Referral Service at 800-525-2225.
My wife, Judy was diagnosed with stage 3b lung cancer, squamous cell. She has received chemo and radiation for 8 weeks. Pet scan Nov. 29, 2012 with results to follow. She, I , nor any of our families have ever smoked. She has never worked in a smoked environment. She is 58 years old and was in good health. During the chemo of Carbuplatin and Taxol her blood counts remained very good. Hair loss minamal. She had two suspected lymph nodes removed. Came back negative. We hope to hear the words on Dec. 11 cancer free. No matter what the outcome, Would she still be a candidate to date for any of your newly formed clinical trials? We are looking for HOPE. Thank you Ron Hathorn
Thank you for your comment. Unfortunately, we can't provide specific medical information on our blog. You would need to consult with one of our physicians who could evaluate whether your wife is a clinical trial candidate. If you are interested in making an appointment with one of our doctors, please call 800-525-2225.
I was diagnosed 2 days ago with mixed adno-squamous cancer. Age 42, zero risk factors. I live in the Chicago area. Do you know of any organizations in this area which do the same generic testing you referred to in the article? Any info you can supply would be most appreciated! Thanks!
We encourage you to reach out to a local physician to discuss options for this type of genetic testing in your area. If you would like to make an appointment with a Memorial Sloan-Kettering physician, please call 800-525-2225.
Sorry... Typing on a smart phone... I meant "genetic" testing. Thanks!
Hi! I live in Naples, Italy and was diagnosed with squamous cell lung cancer - stage 3 - a year ago yesterday. I have done carboplatinum/gemcitabine, had 30 radiation sessions and tomorrow I will start 2nd line of chemo - taxotere. There has been no progression nor shrinkage so far - no mets either. I would like to know of this trial is being done together with the Max Planch Institute/Univ. Of Cologne in Germany or in any other European location that I would be able to travel to. Or perhaps, if I have the qualifications, if I would be able to partecipate "remotely" with the help of my oncologist. Thank you for your kind answer. Best regards, Darby Mudsno
Thank you for reaching out. Dr. Paik notes that while Memorial Sloan-Kettering does not collaborate with other institutions in regard to genetic testing, multiple centers in Europe are running clinical trials of targeted therapies for squamous cell lung cancer. He says that you might try contacting Dr. Jürgen Wolf at the University of Cologne in Germany for information about testing and potential local trials.
Where can I find info. that a lay person can understand, about Cyber-Radiation? It's been reccommended to her , post breast cancer surgery.This was the first time hearing of this procedure. She has turned to me , as a retired R.N. , but I'm clueless. Is this procedure offered at MSKCC? Thank you for any information you can provide.
Thanks for your comment Leona! This video provides a general description of Cyber Knife radiation. For more specific information on radiation therapy for breast cancer, this page includes information on a computer-guided approach, available at Memorial Sloan-Kettering, called IMRT.
Hi, my dad was diagnosed with non small cell (squamous cell) in April of this year. He had 4 treatments of carbo/taxol and had a great response with that. He had lower back pain for a symptom which lead him to go to his doctor and that led to the diagnosis. Aug. 3rd 2012 he had his last chemo treatment and was no longer in pain. His pet scan showed 90% shrinkage of lower lobe tumor. He was then put on Tarceva but had too go off it twice (one week each time) for side effects. His pain is back in the same spot as it was before and will have a ct scan on Dec 5th. My question is, he is 71 yrs old, stage IV...would he be a candidate for this trial and would he have to come to NY or could this be done here in Maine?
Thank you for your comment. Unfortunately, we can't answer personal medical questions on our blog. This includes evaluating clinical trial eligibility for particular patients. If you would like to make an appointment with one of our doctors, please call 800-525-2225.
Hi, What wonderful research Dr. Paik. What drugs and drug companies are involved in your trials? Is there any testing that my doctor can do to identify if I am in the 50% that might benefit by calling you to see about trial participation? Thanks, Sharon
Thanks for your comment! Dr. Paik says that there are three key trials at Memorial Sloan-Kettering fueled by which marker is present. The first includes a drug called AZD4547 (AstraZeneca), the second uses a drug called BKM120 (Novartis), and the third uses an FDA-approved drug for leukemia called dasatinib (BMS). Your doctor can send a tumor sample, if there is enough, to Foundation Medicine, a company in Boston that performs testing for the common targets in all non-small cell lung cancers, including squamous cell cancers. From there, your doctor should be able to guide you to a center that has an appropriate trial. If you live within 1.5 hours of Memorial Sloan-Kettering by car, then we can perform the testing here as well. We can't perform the testing for patients who cannot practically come to participate in early phase studies, as the testing and the studies are linked.
My father in law was detected squamous cell carcinoma in apical segment of left lower lobe encasing branches of left inferior pulmonary artery. The lesion encases segmental bronchus of left lower lobe. on 31-3-2012 Treatment CA LUNG SQ CELL CA STAGE III A CISPLATIN WEAKLY WITH RT POST CT - RT BX POSITIVE FROM RESIDUAL 6 CYCLE PACLITAXEL + CARBOPLATIN completed on 24/1/2013 No significant change has been observed in ct scan or pet condition of patient stable Question 1. Any further treatment like targeted therapy possible 2. How will TAB EVOLITINIB (150) help in this case 3. What are its side effect 4. Can you suggest some other Related Tab which can be more effective in this case
Thank you for your comment. Unfortunately, we cannot answer personal medical questions on our blog. If you would like to make an appointment with a Memorial Sloan-Kettering physician, please call 800-525-2225.
Hi, I am from Macau, China. It's great to read about this exciting development of treatment for Squamous Cell lung cancer. My husband was diagnosed with Squamous Cell carcinoma stage 3 about 4 mouths ago. He has since gone through 22 sessions of radiotherapy and 4 session of chemo (Taxel-carboplatine). We are expected to have a CT scan in about a month to see result and to determine next line of treatment. Dr. Paik, do you know of any medical institutes in Asia that are conducting similar trial? Thank you so much for your help!
We spoke with Dr. Paik, who says that he is unaware of any center that is conducting a similar kind of molecular testing study. However, the closest contact for you would be Dr. Tony Mok at the Chinese University of Hong Kong in Prince of Wales Hospital, who may have trials going on.
I had the University of Iowa Hospitals & Clinics overnight Federal Express my slides & Path Report to Dr. William Travis, Dep't of Pathology, there at MSKCC. The path report that was read here is calling my 4.1 cm upper right lung lobe tumor: poorly differentiated NSCLC with basaloid squamous LC. (a rare type of squamous cancer). I am being recommended Taxol/Carbo - 4 rounds, but I want to make sure this is the right treatment plan. I am wondering if your path dep't will concur with the U of I's findings. I may explore the possibility of coming out there for TX if you think need be. Thank you. Mary in Iowa
If you'd like information about making an appointment at Memorial Sloan-Kettering, you can go to: http://www.mskcc.org/cancer-care/appointment or call 800-525-2225. Thanks for your comment.
I have just been diagnosed with Squamous cell. Its the size of plum and cant be operated on as it's to close to heart. I have had no treatment thus far. I was wondering if the Doctor would find working with me appealing. Please contact me if he would be interested. I live near Pittsburgh Pa. Thank you
Thank you for your comment. Please contact us to make an appointment with a doctor at Memorial Sloan-Kettering: 800-525-2225.

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