The CancerWeb Report, What's New In Cancer: January, 1997
Lung Cancer

• A new marker for therapeutic effect and relapse in small-cell lung cancer - Researchers at the National Cancer Center Hospital in Tokyo, Japan, measured serum levels of a peptide marker called Pro-GRP (pro-gastrin-releasing peptide) in lung cancer patients, reporting their results in the January, 1997 issue of Clinical Cancer Research. At present, levels of neuron-specific enolase (NSE) are often used as a guide to response of small-cell lung cancer. The Japanese researchers found that while the sensitivity and specificity of Pro-GRP (70% and 91%, respectively) were essentially identical to NSE, at the time of relapse after treatment, 94% of patients had elevated Pro-GRP compared to only 37% with raised NSE. In addition, levels of Pro-GRP rose a median of 35 days before there was clinical evidence of relapse, whereas levels of NSE only increased a median of 20 days after relapse was detected by clinical examination and imaging. (Ohe, Clin Cancer Res 3:123, 1997)

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• Intensive chemotherapy for lung cancer - Although there has been marked improvement in the results of treating small-cell lung cancer, more than 80% of patients with extensive or recurrent disease die within 3 years. Intensive chemotherapy has been applied by many researchers , and preliminary results have been encouraging. A report in the January, 1997 issue of the Journal of Clinical Oncology from a group of Japanese researchers who applied one of these promising regimens called CODE (cisplatin, vincristine, doxorubicin, and etoposide) claimed 29% complete and 58% partial responses, with median durations of response and survival of 156 days and 245 days, respectively. There was a 76% incidence of reduced white blood cell counts (Kubota, J Clin Oncol 15:292, 1997). The same issue of the Journal of Clinical Oncology also included an article by a large multi-institutional group of Italian researchers studying other forms of lung cancer, grouped together as non-small-cell lung cancer. Few drugs have produced more than a 15% response rate in this category of lung cancer. However, using two drugs that have been more effective, cisplatin in combination with gemcitabine, they reported an overall response rate of 54% for advanced, Stage IIIB and IV disease with a median survival of 61.5 weeks. Reduced platelet counts was the major side-effect (Crino, J Clin Oncol 15:297, 1997).