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Lee S. Schwartzberg, MD, FACP

Spotlight On Cancer: GI Cancer Research and The West Clinic

Cancer of the gastrointestinal (GI) tract accounts for over 15% of new cancer cases and deaths from cancer in men and women.  Colorectal cancer (CRC) particularly remains a large problem with nearly 150,000 Americans developing this disease and 50,000 dying from it each year.  While screening is proven to be effective at reducing the incidence of CRC, only half of the people recommended having a colonoscopy do so.  The West Clinic is an active supporter of screening and preventative initiatives being coordinated in Shelby County as a strong participant of the Tennessee Comprehensive Cancer Control Coalition. 

Several new agents were approved as treatment for advanced CRC over the past decade.  We now know that patients who are exposed to all active agents, including oxaliplatin, irinotecan, 5-Fluorouracil, bevacizumab, and cetuximab or panitumumab, derive significant benefit.  The median survival of an advanced CRC patient today is over three times longer than it would have been during the 1990’s.  This is remarkable and significant progress.

Nonetheless, there is still a great need to develop newer, more effective therapies for CRC.  The West Clinic is currently evaluating a large number of exciting investigational agents.  The list includes enzastaurin, a protein kinase C inhibitor; sorafenib, a multitargeted, anti-angiogenic drug; AMG-706, another oral anti-angiogenic drug; EZN-2208, a pegylated conjugate of SN-38, the active ingredient in irinotecan; AMG-102, a hepatocyte growth factor inhibitor; AMG 479, an insulin-like growth factor receptor inhibitor. 

Preliminary results from clinical trials conducted at The West Clinic and other research sites were reported at the recent 2010 GI Cancer Symposium held in Orlando, Florida January 21-24, 2010.  This meeting is the premier venue for new clinical research focused exclusively on GI cancers.  The results presented at the symposium are being further extended through our ongoing research trials which will help discern which agents work best and in what combinations. 

Perhaps the most exciting development in CRC recently was the discovery that a certain type of treatment, termed epidermal growth factor receptor (EGFR) inhibitor, works only when a particular gene, known as K-ras, is not mutated in the cancer cell.  This occurs in 60% of patients whereas 40% of CRC has the mutated gene.  Determining K-ras status allows us to tailor therapy to a subgroup of patients most likely to benefit and avoid treating those who won’t.  In essence, selecting patients based on K-ras allows us to get one step closer to truly personalized cancer medicine.  We were proud to be selected as the lead U.S. site in a multinational head to head study of chemotherapy and bevacizumab (an anti-angiogenic drug) vs. chemotherapy plus panitumumab (an anti-EGFR drug) in K-ras wild type patients. This trial will help answer the question of which combination is best at the time patients are first diagnosed with advanced CRC. 

The West Clinic relishes our ability to select high quality clinical trials in GI cancers and other malignancies.  Research allows our patients to gain access to the drugs of tomorrow today, our physicians to gain experience with novel agents before they enter the marketplace, and everyone the opportunity to participate in an endeavor designed to improve the life of cancer patients now and in the future.  The West Clinic will always stand unwavering in our commitment to clinical research. 

Lee S. Schwartzberg, MD, FACP 
Medical Director, The West Clinic
President, Accelerated Community Oncology Research Network, Inc.



Presented in partnership by West Clinic and Memphis Medical News
Celebrating 30 years on the front line of
cancer care.

Past and present, we’re giving more people a future.

901.683.0055     www.westclinic.com

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