The Lowe Center for Thoracic Oncology at Dana-Farber/Brigham and Women’s Cancer Center (DF/BWCC) has been, and continues to be, a pioneer in the discovery and implementation of precision medicine in oncology. Our multidisciplinary team of collaborating physicians and scientists launched a new era in cancer treatment and biology, with the discovery of mutations in the epidermal growth factor receptor gene (EGFR) in a subset of lung cancers that responded dramatically well to treatment with a specific drug, gefitinib.
Even severely ill patients with metastatic cancer showed remarkable responses to this and a related drug, erlotinib, if their cancer samples contained one of the critical mutations in EGFR. This discovery, subsequently confirmed by additional studies around the world, was the first to demonstrate the power of analyzing genetic changes in cancers of solid organs and, importantly, of using those changes to drive treatment, ushering in what we refer to today as precision oncology.
Following the success of the discovery of EGFR, our team continued to make critical discoveries in the biology and treatment of lung cancer including:
- Implementation of the first clinical lab test for EGFR mutations in lung cancer
- Discovery of mutations acquired late, after initial treatment response, that lead to anti-EGFR drug resistance
- Implementation of the first clinical lab tests for acquired resistance to anti-EGFR drugs
- Discovery of new anti-EGFR drugs that can overcome the resistance due to specific acquired late mutations
- Discovery of mutations in genes other than EGFR, including MET, RET, FGFR1, FGFR2, FGFR3, DDR2, and NTRK1, each of which is being studied for response to different specific targeted drugs in clinical trials
- Leading the development of professional practice guidelines for the testing of lung cancers, recognized around the world and endorsed by the principal professional societies for oncology and pathology.
- Implementation of a large panel clinical lab test, using cutting edge “next generation” sequencing technology to study hundreds of genes at once in each cancer sample
- Pioneering the use of blood testing, rather than tissue biopsies, to select therapies for lung cancers and to monitor response to treatment
While we are gratified that our contributions have led directly to new and promising options for patients with lung cancer, we recognize that there is still much yet to be done. We will continue to lead the way in the study of lung cancer biology and in the translation of biologic discoveries into new and better treatments for our patients.
In this video, Pasi A. Jänne, MD, PhD, director of the Lowe Center for Thoracic Oncology, talks about using the targeted therapy crizotinib for patients with a specific dysfunctional gene called ALK.