Patients with more advanced disease, those who are determined to be medically inoperable, and patients whose cancer recurs after surgery as well as patients with SCLC, are treated with chemotherapeutic agents, radiotherapy, or a chemotherapy and radiotherapy combination. Only a minority of tumors show objective clinical responses to chemotherapy: the best platinum-based regimens can induce a clinical response in about 30 to 40% of tumors, while gefitinib or erlotinib, low-toxicity tyrosine kinase inhibitors induce an objective response in about 10% of cases.
Specific molecular features of tumors, particularly EGFR mutations and EML4-ALK fusions, have been shown in multiple studies to have prognostic importance and/or be associated with benefit from specific interventions. Other candidate biomarkers are under study that could be of great clinical significance. In spite of this knowledge, only a tiny minority of patients with lung cancer, especially advanced stage lung cancer, are having these molecular assessments performed.
In response to this widely-acknowledged and systematic barrier to progress against lung cancer, the Addario Lung Cancer Medical Institute (ALCMI) has developed and launched targeted, multi-institutional tissue and data repositories. ALCMI is already helping to revolutionize the current standard of care for lung cancer patients through its inaugural collaborative research project termed CASTLE. The purpose of this clinical trial is to facilitate application of the known biomarkers to patients presenting today, and to establish such a collection of biospecimens that will be useful for discovering and validating new biomarkers for future use.
– Robert O. Dillman, M.D.,F.A.C.P. Executive Medical and Scientific Director, Hoag Cancer Institute