Dr. Wakelee on the Future of Lung Cancer Adjuvant Therapy

Heather Wakelee, MD, assistant professor, Department of Medicine, Division of Oncology, Stanford University, Stanford Clinical Cancer Center, believes the future of adjuvant chemotherapy for lung cancer patients will become more clear once three large European trials are complete. These trials will clarify predictive markers and potential benefits to adjuvant chemotherapy.

The first of the trials is the International TAilored Chemotherapy Adjuvant (ITACA) trial, which is a randomized phase III trial comparing adjuvant chemotherapy, based on thymidilate synthase (TS) and the ERCC1 gene expression, against standard adjuvant chemotherapy in completely resected stage II-IIIA stage non-small cell lung cancer (NSCLC).

The second trial Wakelee mentions is known as the TASTE trial looking at tailored post-surgical therapy in early NSCLC. It is a randomized phase II and III trial that is evaluating the feasibility of standard treatment compared to a customized treatment in stage II or stage IIIA non-N2, non-squamous NSCLC.

Third is a Spanish trial known as GECP-SCAT, which is a randomized study examining customized adjuvant chemotherapy, based on BRCA1 mRNA levels in completely resected stages II-IIIA in NSCLC.

In addition to these clinical trials there are new prognostic gene signatures under investigation that should help predict response to adjuvant therapy.