Persons with non-small cell lung cancer that has spread to other parts of the body often undergo chemotherapy with a combination of drugs, to alleviate the symptoms of disease and prolong survival time. Now, a novel new drug, called decitabine, appears to have activity against this disease, according to preliminary findings presented by Montreal researchers at a recent cancer meeting.

Non-small cell lung cancer (NSCLC) is a term used to describe several types of lung cancer, including epidermoid or squamous carcinoma, adenocarcinoma, large cell carcinoma, adenosquamous carcinoma, and undifferentiated carcinoma. NSCLC may be treated with surgery, radiation therapy, and/or chemotherapy, depending on the stage of the cancer (extent of disease at diagnosis). Persons with stage IV NSCLC have cancer that originated in the lung and then spread to other parts of the body (called advanced or metastatic disease). Several chemotherapy combinations may be used to control the symptoms of disease and prolong survival time, with 2 of the most active being cisplatin/etoposide and cisplatin/paclitaxel. However, researchers continue to develop and study new chemotherapy drugs with the hope of providing more effective treatment options.

Decitabine is a chemotherapy drug that has shown promise in treating myelodysplastic syndrome, a condition that often leads to acute leukemia, a cancer of the blood and bone marrow. In many types of cancer, tumor suppressor genes, the genes that prevent normal cells from becoming cancerous, are not activated and cannot function properly. Decitabine appears to work by reactivating these tumor suppressor genes. Researchers in Montreal studied the use of this new agent in persons with stage IV NSCLC. Fifteen persons with NSCLC received a single 8-hour intravenous infusion with decitabine every 5 to 7 weeks. Six persons, who were able to receive 2 or more chemotherapy cycles, lived for an average of more than 15 months.

From these findings, the researchers concluded that decitabine may hold promise for the treatment of NSCLC; therefore, further studies are warranted. Persons with metastatic NSCLC may wish to talk with their doctor about the risks and benefits of receiving chemotherapy with decitabine or of participating in a clinical trial in which other promising new therapies are being studied. Two sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute (cancer.gov) and the Clinical Trials section and service offered by Cancer Consultants.com (www.411cancer.com). (Presentation at the Tenth International Congress on Anticancer Treatment, 2000)

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