Posted by Rich Miller - email
NASHVILLE, TN (WFIE) - Paula Hart, an Evansville hairdresser, has become the first patient at Vanderbilt-Ingram Cancer Center (VICC) to be treated with an experimental lung cancer drug after doctors there found a rare mutation in her tumor.
The mutation testing is part of VICC's new Personalized Cancer Medicine Initiative designed to tailor each patient's treatment to the unique genetic mutations found in their tumors.
Hart was just 46 when she starting having shortness of breath, along with a nagging cough and intermittent pain in her left shoulder.
After a trip to the emergency room in Evansville and a series of additional tests, doctors finally diagnosed Hart with non-small cell lung cancer. The cancer was already advanced – stage IV.
"It was very shocking," remembered Hart. "I was a recreational smoker. I never smoked full-time and shouldn't have smoked at all. But I also work with chemicals because I'm a hairdresser."
No one could tell her what caused lung cancer in such a young woman with a limited smoking history.
Hart underwent chemotherapy and treatment with a drug that cuts off the blood supply to tumors. Nothing worked.
That's when she found out about VICC's Personalized Cancer Medicine Initiative, where doctors suggested that her tumor be tested for a newly identified tumor mutation in the anaplastic lymphoma kinase (ALK) gene. The mutation is present in only a small percentage of lung cancer patients.
To everyone's surprise, Hart's tumor was positive for the mutation, making her the first VICC patient eligible for a clinical trial of a new investigational drug called crizotinib.
Crizotinib targets a protein encoded by the ALK gene, blocking its activity and causing tumor cells to die.
"Even though the ALK kinase mutation is rare, we are now routinely testing VICC patients with non-small cell lung cancer for the mutation because there are new drugs that appear to work in these patients," said William Pao, M.D., Ph.D., director of Personalized Cancer Medicine. "We're also testing tumors for other mutations so we can prioritize the most appropriate therapy for our patients."
For the past seven months, Hart has been taking three pills twice a day and her symptoms have improved.
The tumors show some shrinkage and there is no evidence the cancer is advancing.
"Now that I'm on the new drug I'm going on with my usual life," explained Hart. "I get up and I have energy. I can stand on my feet for hours at work."
So far, the only side effects have been occasional stomach distress and changes in her vision.
"Ms. Hart is fortunate to have this rare mutation in her tumor that makes her eligible to participate in this clinical trial," said Leora Horn, M.D., assistant professor of Medicine at VICC. "As more effective therapies for other known lung cancer mutations are discovered, we hope to offer these to patients, as well."