DENVER -- Last year, lung cancer killed more men and women in the United States than prostate, pancreatic, breast and colon cancer combined.
But medical breakthroughs have resulted in new targeted therapy medications that are helping patients survive. Patients like Andy Bonnett, a 38-year-old avid kayaker and runner. Looking at him today, you would never guess he’s a cancer patient.
Four years ago, Andy had some pain in his rib cage, but figured he’d pulled a muscle. After physical therapy didn’t work, he went for a second opinion.
The diagnosis was not good, and something he’ll never forget. “Stage four, non-small cell lung cancer.” At just 34 years old, doctors told Andy, he had lung cancer, and it had spread to his brain. Devastating news to someone who had only smoked occasionally, but stopped some eight years before his diagnosis. “Turned my life around, completely.”
As is typical with stage four patients, Andy was placed on aggressive chemo treatments, and heavy doses of pain pills. “I was on a lot of hard core medicine where they didn’t think I’d make it. It was a long shot.”
But doctors at University of Colorado Hospital were willing to take a shot. Dr. Ross Camidge is Andy’s oncologist and says Andy was “asking himself serious questions about where things are going.”
Dr. Camidge tested Andy’s cancer for a certain gene, that makes an abnormal protein which drives cancer growth.
Turned out, Andy had that gene, and he was put on a clinical trial for a drug called Crizotinib. Dr. Camidge describes how it works. “This goes in and it just shoves a gag in the mouth of that abnormal protein, and says you can’t tell us what to do. And without that leader in the cancer cell, the cancer cell dies off.”
Within just two days of his first treatment, Andy was off pain killers. Dr. Robert Doebele is a leading expert in targeted therapies like Crizotinib. “Chemo therapy might cause response in 25 percent initially and later on only 10 percent. These drugs generate response in 60-70-80 percent of patients and also last a lot longer, and with fewer side effects.”
Crizotinib, and three other drugs, are now FDA approved for non-small cell lung cancer. They include Afatinib, Erlotinib, and Bevacizumab, all sold under their respective brand names.
Despite Andy’s initial response to the treatment, his battle isn’t over.
Dr. Doebele says when you treat cancers with a drug, “it may work initially to kill 90 percent of the cancer cells, or a very large percentage of the cancer cells, but because they’re changing so rapidly, they can evolve to beat the therapy.”
That’s why Dr. Doebele and others at University of Colorado Cancer Center are constantly trying to stay ahead of the curve by testing new treatments, so they know how cancers will respond.
“Whether every single patient will be able to benefit with these, I don’t know, but that’s the hope. Clearly a large percentage of cancer patients will be able to benefit from this type of precision medicine approach.”
Andy is now on a new trial drug called AP26113 because his cancer adapted to Crizotinib and stopped responding, but the new treatment seems to be doing the trick. Andy says, “right now the scans are showing no sign of activity whatsoever.”
Unlike Andy, who’s an active runner and kayaker. The results, and Andy's activities, are things that bring a smile to the face of Dr. Camidge. “If you’re doing your job right as an oncologist, you should be jealous of your patients’ lives, and that’s exactly what’s going on with Andy.”
Although Andy’s case is amazing, doctors say targeted therapies are not a cure for cancer, just a much more effective way of managing the disease.
University of Colorado Hospital puts 30-40 percent of cancer patients on clinical trials -- about 10-times the national average. Meantime, survival rates are roughly four-times the national average.
For anyone looking for a second opinion, Here’s the clinic’s contact info:
For an appointment with a University of Colorado physician, please contact Bethie Jean Philippe (720-848-3386), intake coordinators for the lung cancer program.