PoweRD 2 Cure ALK+ Lung Cancer TeamLab
Emerging therapies for lung cancer offer significant benefits, especially for patients with ALK-positive tumors. However, resistance to these treatments is almost inevitable. By focusing on residual disease, which is often overlooked by translational research, the PoweRD 2 Cure ALK+ Lung Cancer TeamLab aims to prevent resistance and develop strategies that can be applied to other lung cancer subtypes.
PROJECT HIGHLIGHTS
The PoweRD 2 Cure ALK + Lung Cancer TeamLab project is supported in partnership with ALK Positive Inc., a foundation funded by patients with ALK-positive lung cancer and their families. Learn more about ALK Positive Inc. here.
- ALK-positive lung cancer is a specific type of non-small cell lung cancer that tends to occur in never-smokers and in younger patients.
- It is defined by a distinctive, measurable genetic change in lung cells leading to continuous activation of the ALK protein. Despite advances with ALK-inhibiting drugs, these therapies are rarely curative.
- Residual disease occurs when a small number of malignant cells escape the initial treatment. These cells fuel the cancer’s recurrence and spread, which is a key challenge not only in ALK-positive cancer, but across many types of lung cancer.
- The PoweRD 2 Cure ALK+ Lung Cancer TeamLab will work to identify and exploit the vulnerabilities of residual cancer cells and collaborate with industry partners to test novel therapies that target those weak points
- The ultimate goal is to develop treatment strategies that leave no cancer cells alive, thereby transforming advanced lung cancer into a curable disease.
MEET THE TEAM
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PROJECT SUMMARY
Like all cancers, lung cancer is caused by alterations in genes that collectively drive cells to divide and grow in the absence of the normal controls. In the case of ALK-positive lung cancer, which frequently strikes younger patients who have never smoked, the key driver of disease development is the rearrangement and fusion of two genes: ALK (anaplastic lymphoma kinase) and another gene, most commonly EML4. This gene fusion produces an abnormal ALK protein that causes cancer cells to grow and spread.
ALK inhibitors were developed to specifically target ALK to kill cancer cells. These drugs, typically pills taken once or twice per day, have been shown to slow or stop the progression of the cancer. However, most of them stop working because the cancer develops resistance.
Resistance occurs when a small number of malignant cells escape the ALK-targeting therapy. This residual disease (RD) state fuels the cancer’s recurrence and spread. The goal of this project is to transform the care of lung cancer by developing a deeper understanding of the RD state and identifying novel ways to target these persistent cancer cells, ultimately aiming to prevent relapse and improve patient outcomes.
Toward that goal, the PoweRD 2 Cure ALK+ Lung Cancer TeamLab is pursuing three specific research aims.
Recognizing the critical bottleneck in accessing and analyzing clinically relevant samples and data to advance RD science and interventions, the first aim is to demonstrate the feasibility of acquiring and analyzing residual disease plasma and tissue samples from ALK-positive patients and initiating pilot radiomic analyses to quantify the RD state. Patient samples will first be collected at participating institutions before establishing a framework to enable nationwide patient sample donation. This will enable the team to expand their understanding of ALK-positive tumor biology as it evolves during treatment with ALK inhibitors; develop metrics for quantifying RD and identifying ALK-positive patients at higher risk of progressive disease; and define new clinical trial endpoints.
The second aim is to identify which preclinical models of RD best represent features of patient RD states. The team plans to do this by systematically interrogating a defined set of in vivo and in vitro models of ALK-positive RD to establish the biological features shared with patient-derived samples of RD, such as cancer cell and immune cell states. Establishing these models will provide a crucial foundation for future efforts to better assess interventions during preclinical and trial studies, improving the ability to predict treatment responses in patients with RD.
The third aim is to initiate the development of a multi-center clinical trial framework to accelerate clinical evaluation of novel therapies aimed at eradicating RD. This involves initiating development of a master protocol clinical trial for biospecimen collection and assessment, designed to overcome the lack of available RD tissue for study. The team will initially analyze samples from patients receiving localized consolidation therapy (LCT), a treatment that focuses on controlling cancer in specific areas after initial therapies. They expect to then add additional interventional treatment arms including cancer vaccines. By studying samples at the start of and during each treatment, the team aims to learn more about RD and guide the development of new treatments targeting this hard-to-treat state.
Through these collaborative studies, this project aims to leverage biospecimen collection, advanced laboratory techniques, and biopharma partnerships to change the face of treatment for patients with RD, ultimately improving the quality and duration of life for those diagnosed with lung cancer.
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