Dr Malinda Itchins & Dr Sarah Hayes - Funded 2018


Predicting response to treatment in the ALKternate clinical trial for lung cancer often affecting the young, fit and never smokers

GOAL: Monitor ALKternate trial patients by DNA and proteomic analysis of blood plasma collected at set time points throughout the trial.

Dr Malinda Itchins, together with Dr Sarah Hayes, both based in the Bill Walsh Translational Cancer Research Laboratory at RNSH, will undertake DNA and proteomic testing of blood specimens collected from ALK+ lung cancer patients on the ALKternate trial.

Lung cancer is no longer a disease of older people with long-term smoking habits. ALK+ lung cancer is diagnosed in up to 7% of patients and these patients are typically young and fit and have never smoked. In this cancer, the ALK gene is broken and fused to another gene creating a new gene that drives the growth of cancer cells. This cancer is usually diagnosed when the disease is advanced or inoperable. 

Their laboratory has designed a clinical trial for ALK+ lung cancer patients who have become resistant to the currently used TKI drugs. At this stage of their disease these young patients have no further treatment options and their estimated survival is reduced to 3 months. This trial, (ALKternate) the first of its kind in the world, will investigate whether alternating 2 different drugs instead of treating continually with one, will suppress the development of drug resistance and improve survival for these patients. 

The aim of this Fight for a Cure project is to monitor ALKternate trial patients by DNA and proteomic analysis of blood plasma collected at set time points  throughout the trial. Comparison of these results with patient outcomes will determine whether analysis of DNA mutations and or proteins in blood plasma can predict drug resistance before the cancer is shown to grow on scans and the patient's condition deteriorates due to developing symptoms. Predicting patient response will enable a change in treatment before a patient becomes sick thus optimising their ongoing quality of life and survival.

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