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A combination of two drugs—Vidaza® (azacitidine) and the investigational drug entinostat—has shown promise in the treatment of some patients with advanced, previously treated, non-small cell lung cancer. These results were published in Cancer Discovery.

Lung cancer remains the leading cause of cancer death in theUnited States. Non–small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers.

Treatment of NSCLC may involve surgery, chemotherapy, targeted therapy, radiation therapy, or some combination of these approaches. For patients who experience a worsening of their cancer in spite of several previous treatments, treatment options are limited.

One promising area of research in the understanding and treatment of cancer involves epigenetics. Epigenetics refers to factors that affect which genes are turned on or off in a particular cell. Cancer cells may have epigenetic changes that lead to uncontrolled cell growth. Drugs that target these changes may slow or stop cancer growth.

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Vidaza and entinostat are drugs that target certain epigenetic abnormalities. To explore the combination of these two drugs in patients with metastatic, previously treated NSCLC, researchers conducted a Phase I/II clinical trial among 45 patients. All study participants were treated with Vidaza and entinostat.

  • Of the 45 patients, one had a complete response to treatment (a disappearance of detectable cancer) and one had a partial response to treatment. An additional ten patients had a stabilization of their cancer that lasted at least 12 weeks.
  • Although only a small number of patients responded to treatment, the responses that occurred were impressive. Researchers are now trying to understand which patients are likely to respond to this type of treatment and which are not.
  • 19 patients received additional anticancer treatment (either chemotherapy or targeted therapy) after Vidaza and entinostat, and four of the 19 had good responses to these additional treatments.

This study suggests that a combination of epigenetic treatments may be effective for selected patients with NSCLC. Although the current study focused on patients who had already received extensive prior treatment, these drugs may also prove to be effective when used earlier in the course of NSCLC treatment; researchers will explore this question.

Reference: Juergens RA, Wrangle J, Vendetti FP et al. Combination epigenetic therapy has efficacy in patients with refractory advanced non-small cell lung cancer. Cancer Discovery. 2011;1:598-607.

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