Treating Resistant Lung Cancer

There's an under-utilized test that can help your oncologist prescribe the right mix of chemo to battle your tumor. Lung cancer is difficult to treat. Nearly 60 percent of patients die within a year of their diagnosis; 75 percent die in two years. Thomas d’Amato, M.D., Ph.D., a Thoracic Surgeon with Thomas Jefferson University Hospital, says the biggest reason for lung cancer treatment failure is because the tumor is resistant to the chosen chemotherapy medications (i.e., is able to withstand the toxic effects of the drugs).

Doctors have several drugs to choose from when deciding on the best treatment for a lung cancer patient. However, not all drugs or drug combinations work. Thus, in addition to having to endure side effects of treatment, the therapy itself may provide little or no benefit in fighting the cancer.

D’Amato recently completed a study analyzing the resistance of more than 4,570 lung cancer tumors to four paired combinations of chemotherapy drugs: carboplatin and paclitaxel, cisplatin and navelbine, cisplatin and docetaxel and cisplatin and gemcitabine. He took samples of each patient’s tumor during surgery. Then, using a special laboratory test, called a chemotherapy sensitivity assay, d’Amato found resistance to carboplatin and paclitaxel in 30 percent of the tumors, 24 percent were resistant to cisplatin and navelbine, 42 percent were resistant to cisplatin and gemcitabine, and 27 percent to cisplatin and docetaxel.

D’Amato says the chemotherapy sensitivity assay provides doctors with a good indication of how well a cancer will respond to a particular treatment and can help patients avoid drugs that are likely to be ineffective. The test is available through many laboratories, but doctors don’t always use it.