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National clinical trials offered at Massey utilize precision medicine aimed at improving treatment of early-stage lung cancer

ALCHEMIST uses next-generation sequencing to identify patients with early-stage lung cancer whose tumors harbor specific and uncommon changes in two particular genes thought to drive cancer growth.

VCU Massey Cancer Center is currently offering clinical trials for patients with early-stage lung cancer that utilize cutting-edge precision medicine techniques with the aim of improving treatment. This group of three integrated national clinical trials known as ALCHEMIST – Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials – use next-generation sequencing to identify patients with early-stage lung cancer whose tumors harbor specific and uncommon changes in two particular genes, epidermal growth factor receptor (EGFR) and anaplastic lymphoma receptor tyrosine kinase (ALK), thought to drive cancer growth. The goal of ALCHEMIST is to determine whether treatments targeted against those particular gene alterations are more effective in preventing recurrence and improving survival than the current standard of care involving chemotherapy with or without radiotherapy after the tumor’s removal.

ALCHEMIST calls for patients with certain types of early stage non-small cell lung cancer (NSCLC) who are planning to or have undergone complete surgical removal of their tumor and whose type of cancer is likely to exhibit the EGFR or ALK genetic changes. The non-squamous subtype of NSCLC represents roughly 60 percent of all lung cancers, and patients with this type of cancer are more likely to qualify for ALCHEMIST than those with other types of lung cancer. Even then, only about ten percent of people in the United States with non-squamous NSCLC will have tumors with EGFR gene mutation and only five percent will have ALK gene rearrangement.

Sherman Baker, Jr. M.D., is leading ALCHEMIST at Massey.

ALCHEMIST is comprised of three components: the screening where the tumor is genetically tested to determine if it exhibits either of the genetic alterations and the treatment for those alterations—EGFR treatment and ALK treatment. Each treatment trial will evaluate the efficacy of a drug targeting the particular gene mutation, and participants after receiving standard therapy will be randomly assigned to receive either that drug or a placebo. The drugs, erlotinib and crizotinib, have already been approved by the U.S. Food and Drug Administration (FDA) for the treatment of patients with advanced forms of lung cancer with EGFR and ALK gene alterations, respectively, but ALCHEMIST hopes to discover whether those treatments will help patients earlier—right after their tumor has been surgically removed and they are clinically disease free.

ALCHEMIST is supported by the National Cancer Institute (NCI) with coordination of the component trials by the Alliance for Clinical Trials in Oncology and the ECOG-ACRIN Cancer Research Group. At Massey, the clinical trial is led by Sherman Baker, Jr. M.D., medical oncologist and member of the Developmental Therapeutics research program at Massey and associate professor in the Division of Hematology, Oncology and Palliative Care at the VCU School of Medicine.

ALCHEMIST trials are now open at Massey’s downtown, Stony Point and Community Memorial Hospital clinics and at Massey’s clinical research affiliates: Hematology-Oncology Associates of Fredericksburg, Inc. and Virginia Cancer Institute. Those interested in enrolling or learning more about this clinical trial should contact Massey’s Clinical Trials Office at (804) 628-2364 and reference clinical trial A151216.

VCU Massey is currently conducting more than a dozen lung cancer clinical trials and more than 100 total trials on a variety of cancers. View a complete list of all active clinical trials available at Massey.

Written by: Liza Janssen

Posted on: March 10, 2015

Category: Clinical news