Study Identifies Gene Alterations in Lung Cancer

An international team of scientists, supported in part by the National Human Genome Research Institute (NHGRI), one of the National Institutes of Health (NIH), has announced that its systematic effort to map the genomic changes underlying lung cancer has uncovered a critical gene alteration not previously linked to any form of cancer. The research, published in the advance online issue of the journal Nature, also revealed more than 50 genomic regions that are frequently gained or lost in lung adenocarcinoma, the most common type of lung cancer in the United States.

“This view of the lung cancer genome is unprecedented, both in its breadth and depth,” says senior author Matthew Meyerson, a senior associate member of the Broad Institute of MIT and Harvard in Cambridge, Mass., and an associate professor at Dana-Farber Cancer Institute and Harvard Medical School in Boston. “It lays an essential foundation, and has already pinpointed an important gene that controls the growth of lung cells. This information offers crucial inroads to the biology of lung cancer and will help shape new strategies for cancer diagnosis and therapy.”

Each year more than 1 million people worldwide die of lung cancer, including more than 150,000 in the United States. The new study focused on lung adenocarcinoma, which, according to the National Cancer Institute (NCI), is the most frequently diagnosed form of lung cancer in the United States, accounting for approximately 30 percent of cases.

New approaches to cancer treatment rely on a deeper understanding of what goes wrong in tumor cells to spur uncontrolled growth. Through decades of research, it has become clear that lung cancer -- like most human cancers -- stems mainly from DNA changes that accrue in cells throughout a person’s life. But the nature of these changes and their biological consequences remain largely unknown, which has inspired the recent formation of multi-disciplinary teams that are using new genomic tools and technologies to study cancer in a more systematic, comprehensive manner.

The latest study was conducted as part of the Tumor Sequencing Project (TSP), an ongoing effort to apply large-scale approaches to the identification of genomic changes in lung adenocarcinoma. NHGRI is a major funder of TSP, which unites scientists and clinicians throughout the cancer research community.

“This outstanding work clearly demonstrates the value of comprehensive approaches for exploring the genomic underpinnings of cancer. The impacts of these findings extend far beyond lung cancer and indicate that many more important cancer-related genes still await our discovery,” NHGRI Director Francis Collins says. “Now, we must forge ahead and apply this strategy as quickly as possible to other common types of cancer.”

Specifically, the TSP researchers uncovered a total of 57 genomic changes that occur frequently in lung cancer patients. Of these changes, more than 40 appear to be associated with genes not previously known to be involved in lung adenocarcinoma. More research is needed to precisely identify and characterize these genes, but researchers are excited by the possibility that their findings may suggest new ways of attacking this deadly cancer.

The most common abnormality identified by the TSP team involves a region on chromosome 14 that encompasses two known genes, neither of which had been previously associated with cancer. Through additional studies in cancer cells, the researchers discovered that one of the genes, NKX2.1, influences cancer cell growth. NKX2.1 normally acts as a master regulator that controls the activity of other key genes in cells lining the lungs’ tiny air sacs, called alveoli. The discovery that a gene functioning in a select group of cells - rather than in all cells - can promote cancer growth may have broad implications for the design of drugs for a wide range of cancers.

“The genomic landscape of lung cancer gives us a systematic picture of this terrible disease, confirming things we know, but also pointing us to many missing pieces of the puzzle. More broadly, the study represents a general approach that can and should be used to analyze all types of cancer,” says Eric Lander, one of the study’s co-authors and founding director of the Broad Institute of MIT and Harvard.

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A New Target for the Treatment of Breast Cancer

The active ingredient in a drug currently being tested to treat rheumatoid arthritis might also one day serve as an effective means of treating one of the deadliest forms of breast cancer.

Researchers with the U.S. Department of Energy’s Lawrence Berkeley National Laboratory have demonstrated that inhibiting the activity of the protease enzyme known as TACE can deprive tumor cells of a key factor needed for their proliferation. TACE is strongly present in a form of breast cancer which responds poorly to current therapies

“We have shown that inhibition of the TACE protease in breast cancer cells blocks the shedding of two critical growth factor proteins and results in an inhibition of a key signaling pathway that controls cell division,” says Paraic Kenny, a post-doctoral cell biologist with the research group of Mina Bissell in Berkeley Lab’s Life Sciences Division. “Based on analysis of cells grown in three-dimensional cultures, the inhibition of this protease results in the reversion of the malignant phenotype of these breast cancer cells and switches their behavior back to a phenotype very reminiscent of non-malignant breast epithelial cells.”

Kenny is the co-author along with Bissell of a paper published in the Journal of Clinical Investigation titled: "Targeting TACE-Dependent EGFR-ligand Shedding in Breast Cancer." This paper presents the latest experimental results from an on-going investigation led by Bissell into the ecology of tumors.

It has long been Bissell’s contention that “no tumor is an island.” Tumor cells, she maintains, exist in the same microenvironment as healthy cells and must therefore appropriate normal physiological processes to facilitate their growth and spread. As she and her colleagues have repeatedly demonstrated, this idea can open up potential new avenues and targets for diagnostic and therapeutic applications.

For this latest paper, Kenny and Bissell looked into the pathway by which the EGFR signal is carried. EGFR, which stands for Epidermal Growth Factor Receptor, is the protein on the outer surface of a cell that is activated by EGF and related growth factors and signals for the cell to divide. Given that one of the hallmarks of cancer is cell division run amok, the reduction of high levels of EGFR activity has long been a primary target for anti-cancer drug development. So far, however, drugs aimed at directly inhibiting EGFR activity have met with only limited success in the cancer clinic, primarily in a small number of lung cancers.

“Because of this, we turned our attention to the processes that regulate the production of the ligands which bind and activate EGFR,” Kenny says. “We reasoned that this binding and activation is essential for EGFR activation and that finding a way to block this interaction might prove to be an important additional approach to explore for inhibition of this pathway.”

Kenny stresses that the importance of EGFR to so many different tumor types, including lung, head and neck, bladder, colorectal and kidney, makes it likely that “TACE inhibition has the potential to be an effective means of stopping tumor growth for EGFR-dependent cancers outside the breast as well.”

<---We all know someone or are some one who has or have had cancer. The most common for women is breast cancer. Slow progress is made in the battle. A new vaccine prevents a virus that causes cervical cancer. Still cancer has no vaccine, nor cure. Scary too is the rise in cases of prostate cancer in men 18-37.--->

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Combination Therapy Shows Improvement for Breast Cancer Patients

Giving radiation therapy and chemotherapy at the same time after a lumpectomy helps keep breast cancer from returning locally, according to a study published in the Dec. 1 issue of the International Journal of Radiation Oncology, Biology and Physics, the official journal of the American Society for Therapeutic Radiology and Oncology Inc. (ASTRO).

Breast cancer widely affects women in the United States, with more than 213,000 women estimated to be diagnosed in 2006. For early-stage breast cancer, the standard treatment is a lumpectomy (surgical removal of the tumor) followed by radiation therapy to the entire breast. Doctors usually recommend chemotherapy in addition for women with invasive disease. When to give the chemotherapy -- whether after surgery, but before radiation or after surgery and radiation -- has been widely debated among researchers.

Cancer researchers at Yale New Haven Hospital in New Haven, Conn., and the Cancer Institute of New Jersey, New Brunswick, N.J., wanted to try to answer the question as to the proper sequencing of chemotherapy. Doctors recorded data from more than 2,000 patients over the course of nearly 25 years. Of those women, 535 patients were treated with the different sequencing of chemotherapy and radiation therapy. Patients were then grouped by how they received the treatment, 276 women received chemotherapy before radiation therapy, 106 women received radiation therapy before chemotherapy, 109 women received concurrent chemotherapy and radiation, and 44 women received the "sandwich" technique of alternating chemotherapy with radiation therapy and then repeating chemotherapy.

The outcome for the women in the study was successful across the group, with 10-year overall survival at 78 percent. Doctors found that there was no significant difference in the way these combinations affected the general patient outcome, but there was a difference in where tumors could relapse. Of the 109 patients who received chemotherapy and radiation therapy at the same time, only 8 percent relapsed locally (in the conservatively treated breast) over 10 years.

Of the women who received radiation therapy before chemotherapy, 13 percent had a local relapse while 22 percent of the women who had chemotherapy before radiation had a local relapse.

"It is important for doctors to test and retest combinations of treatments and how we deliver them to our patients. In this retrospective analysis, by concurrently administering chemotherapy and radiation therapy, there appears to be a benefit to selected patients in terms of local control of the breast cancer. The challenge over the next few years is to identify those patients who would best benefit from this strategy. This can best be accomplished by prospective clinical trials," says Bruce Haffty, M.D., lead author of the study and a radiation oncologist at Robert Johnson Wood Medical School-UMDNJ and the Cancer Institute of New Jersey, in New Brunswick, N.J.