HOUSTONThere are currently 581 clinical trials underway
at The University of Texas M.D. Anderson Cancer Center, John
Mendelsohn, MD, the Centers president, said at a seminar held
in conjunction with the opening of the Centers new Alkek
Most protocols are treatment trials, Dr. Mendelsohn said, but one
groundbreaking study is a prevention trial aimed at lung cancer,
using retinoic acid, a form of vitamin A.
Jonathan M. Kurie, MD, of the Department of Thoracic/Head and Neck
Medical Oncology, is leading the study. The relative lack of
success we have had in the treatment of established lung cancer
points us toward intervening at earlier stages of the disease,
The best prevention strategy for smokersquittingis
obvious, but this answer is not so simple, Dr. Kurie
said. Now, over 50% of all lung cancers occur in people who
have quit smoking. Recent reports show that former smokers have
an increased risk of developing lung cancer even up to 30 years after stopping.
Early clinical trials of retinoic acid in the 1980s showed a reduced
incidence of second cancers in patients who had undergone resection
of a head and neck cancer. The new trial, being conducted by Dr.
Kurie and colleagues at M.D. Anderson and the University of Texas
Southwestern Medical Center at Dallas, targets former smokers.
We are trying to answer several questions, he said.
First, we want to learn to identify individuals in the
population of former smokers who are at increased lung cancer
risk. Toward this end, Drs. Margaret Spitz, Walter Hittelman,
and Li Mao are trying to identify two kinds of genesgenes that,
if inherited, confer increased lung cancer risk and genes that, if
damaged by cigarette smoke, lead to the development of lung cancer.
The second trial objective is to test the effectiveness of different
vitamin-A-related drugs in repairing the damage caused by previous
smoking. Potential benefits for participants include early detection
of a potentially cancerous condition and possible reduction of
Each study participant undergoes bronchoscopy and biopsy at six
predetermined sites inside the lung. These samples are then studied
for evidence of damage to the chromosomes known to be damaged by lung
cancer (3P, 9P, 17P). Were looking at those areas for
evidence of change so we can quantitatively assess the amount of
damage, Dr. Kurie said.
Participants are then randomized to receive a placebo or retinoic
acid. After treatment for 3 months, a second bronchoscopy and repeat
biopsies are performed. Again, Dr. Kurie said, we
get a quantitative measure of the damage, so that we will be able to
determine whether the treatment had any effect.
To date, the study has shown that more than 50% of participants, all
former smokers, have a tremendous amount of DNA damage,
Dr. Kurie said. He called the study groundbreaking, since no
one has ever shown this sort of damage before in former smokers. We
were absolutely astounded at what we saw. I think the problem is much
more profound than we thought.
People who have successfully stopped smoking are being sought for
this ongoing trial. Contact the Research Nurse, Department of
Thoracic/Head & Neck Medical Oncology, (713) 745-2784.