Molecular fingerprints  pg. 9

“Different patients may respond to different cocktails, so the more you know about the biology of cancer, the more likely you are to be able to develop intelligent therapies,” Carbone says.

That’s why Carbone is carefully analyzing and cataloging the patterns of proteins found in the lung tumors removed from patients.

The patients will be followed and, over time, the researchers will see if there are unique patterns that correlate with specific outcomes, such as a recurrence of the cancer in the brain, response to chemotherapy, or poor survival. Eventually, they hope to be able to predict the course of a patient’s disease shortly after they remove his or her tumor, and plan treatment accordingly.

“If we know this tumor will have a propensity to go to the brain, we can give prophylactic cranial irradiation,” Carbone says. “If you knew this tumor was going to respond to chemotherapy, then you might consider giving adjuvant chemotherapy after surgery.”

Pierre Massion, M.D., assistant professor of Medicine and Cancer Biology at Vanderbilt, is working with Carbone on a related study—testing tissues removed from the lungs of smokers who do not have cancer, to see if they can predict which smokers are likely to develop cancer in the future.

“The whole paradigm has shifted,” says Carbone. “Ten years ago, we had a couple of drugs, they weren’t very effective and most people weren’t receiving them. Now we have a huge number of … interesting, molecularly targeted therapeutics out, and some of them are showing real clinical responses.

“I think a new era in lung cancer has started.”

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