The first question a person diagnosed with lung cancer should ask themselves is this: what type of cancer do i have? Normally cytology (the examination of the cells present in the bronchi) or biopsy, that is the analysis of the neoplastic tissue, which give a first answer (but today the so-called liquid biopsy which looks for cancer cells in the blood). From these tests it is clear whether a patient has a so-called non-small cell tumor (in acronym Nsclc), the most frequent: it represents 80-90 percent of all malignant lung neoplasms; or other forms (among these, the most frequent is microcytoma than in small cells).

Personalized medicine

Here is the second question, the one that many patients often do not know they have to ask: what are the genetic characteristics of my tumor? Because today the treatment of this disease, thanks to the new so-called molecular target drugs that are gradually becoming available, affects precisely these genetic alterations which, in fact, are at the base of the neoplasm. this is the gist of personalized medicine which is evolving day by day and also becoming more and more complex: especially in metastatic lung cancer these alterations can be very numerous. But let’s go back to the patients. What do they know about these new diagnostic and therapeutic opportunities? of great interest a research, presented at the last congress of the World Conference on Lung Cancer of the Iaslc (International Association for the Study of Lung Cancer), recently held online.


Lost in translation

He talked about it Anne Marie Baird, President of Luce (Lung Cancer Europe) and among the many data she presented, in a slide entitled Lost in translation, one catches the eye: roughly 31 percent of patients are unaware of any genetic alterations related to their cancer. This is why, on the one hand, patients need to be informed and, on the other, these tests need to be truly accessible and (hopefully) reimbursable by national health systems. In all of this, it is precisely the patient associations that could play a role in raising awareness. It is their chance to get the best treatment for their disease. The problem, as Anne Marie Baird pointed out, is that of translate the information coming from genetics into clinical practice.

The mutation of the Gene Kras

Because some drugs that work (on some of the known genetic alterations) are already there, others are on the way, particularly with regard to a mutation in the Kras gene, which researchers are focusing on. Until now this mutation was considered “undraggable”, that is, not attackable by drugs – he recalled Matthias Scheffler, of the University of Cologne (Germany) -. But things are changing. A study, presented at the congress, showed that an experimental drug, called sotorasib, given to patients with metastatic non-small cell lung cancer with a particular Kras mutation, called Kras G12C, able to control the disease. So far, these patients have no effective therapy available. The study is still preliminary, although encouraging, and new results are awaited to understand how these first results can be translated either into what is called the “disease-free period” (a phase in which the tumor does not show signs of self) or , even better, in an increase in survival. To date, there are no approved therapeutic options specifically directed against the mutated Kras protein – he comments Umberto Malapelle of the Laboratory of Predictive Molecular Pathology of the Department of Public Health of the University of Naples Federico II -. After so many years of failure, the data on this new drug represent a light at the end of the tunnel.

March 31, 2021 (change March 31, 2021 | 11:13 am)

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