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Cancer co-opts normal growth signals in pancreas and lung cancer

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ASCO 2009

kopetz1.jpgResearch presented at ASCO this year improves our understanding of how cancer cells make use of factors that regulate normal cell growth.  Our normal cells grow, divide, and use energy in the form of glucose under very tight control.  The result is a coordinated system of cells that only multiply when the conditions are right in the body, meaning that we have enough energy to support the increased numbers of cells.  This system normally regulates our body size and circulating energy levels, and is related to obesity and diabetes.

We increasingly understand how one part of this system (called the insulin-like growth factor receptor or IGFR) is co-opted by cancer cells in order to maintain their growth.  Work presented this morning by Dr. Shroff, a medical oncology fellow working with Dr. Dongyu Li in the Department of Gastrointestinal Medical Oncology, demonstrated that variations in the IGFR gene resulted in differences in outcomes for patients with advanced pancreas cancer.  This effect was fairly strong, as survival time was twice as long in patients with the "good" gene variation.  In the discussion that followed the presentation, it was noted that this IGFR system may play a significant role in the growth and spread of pancreas cancer.

The next goal is to take advantage of this finding to improve outcomes for cancer patients.  Fortunately, there are a number of chemotherapies in development that may block the IGFR system.   One such agent in development in lung cancer, as reported by Dr. Daniel Karp in the Department of Thoracic/Head and Neck Medical Oncology, is showing an impressive benefit in patients with a certain type of non-small cell lung cancer.  In updated results he presented at ASCO (#8072), he reported a response rate of above 60% in patients treated with an IGFR inhibitor plus chemotherapy, with several patients with dramatic responses.  We hope these are only the first of several good reports for agents targeting IGFR, as this approach has the potential to benefit not just patients with pancreas and lung cancer, but a host of broader tumor types.

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