The CTC’s TIMELY trial was presented last month at the annual
IASLC World Conference on Lung Cancer by Dr Adam Januszewski, clinical fellow and specialist registrar at Imperial College London.
The conference is the world’s largest international gathering of clinicians, researchers and scientists in the fields of lung cancer and thoracic oncology, with delegates from more than 100 countries in attendance. Also present were Dr Riyaz Shah and Dr Mary O’Brien (pictured above), two of the treating medical oncologists on the trial, along with the chief investigator Dr Sanjay Popat.
The TIMELY trial has been running at the CR UK & UCL Cancer Trials Centre since 2013, and has treated 39 non-small lung cancer patients with an oral drug called afatinib. These patients were unfit for chemotherapy and had either a suspected or confirmed EGFR mutation.
The study hopes to show that the drug afatinib can safely help prevent the cancer's growth within the first 6 months of treatment. This has so far been poorly explored in patients who are unfit for chemotherapy, who may not have other treatment options available to them where their EGFR status is unknown.
The study collected tissue and regular blood samples from the patients before treatment, during their treatment, and when their disease worsened. These were analysed by Dr Januszewski and trial statistician Prof Allan Hackshaw.
Dr Popat remarked: ’It was a pleasure to present the translational results of the national TIMELY phase 2 trial at the conference in Toronto with my colleague Dr Januszewski. We were delighted to be joined by Drs Shah and O’Brien, both PIs on this trial.
‘Our work was very well received, demonstrating that longitudinal ctDNA NGS sampling plays a very useful role in the treatment of patients with proven or suspected EGFR mutant non-small cell lung cancer in three ways: (1) by identifying EGFR mutation status when tissue is inadequate for genotyping, (2) by predicting those most likely to derive benefit by achieving a molecular remission on treatment, and (3) by identifying molecular mechanisms of acquired resistance both at EGFR and beyond.’
In conclusion, the circulating tumour DNA in the blood results indicated that patients benefit from afatinib, and that patients who had a reduction of the circulating tumour DNA had a strong association with better survival.
More details on the trial can be found
here.
Photo: Adam Januszewski