Straight to the lungs: Inhaled chemo lessens collateral damage

In Clinical Trials by Barbara Jacoby

By: Katrina Burton

From: mdanderson.org

MD Anderson researchers are examining the use of inhaled chemotherapy to treat cancer that has spread to the lungs from other sites in the body. They hope to find that the inhaler delivers the chemotherapy drug directly to the lungs where it treats lung tumors while sparing healthy organs.

A new way of treating cancer that spread to the lungs from another site in the body is being studied at MD Anderson Children’s Cancer Hospital.

“Certain cancers that spread to the lungs are treatable with intravenously delivered chemotherapy drugs,” says Najat Daw, M.D., professor of Pediatrics and lead investigator of the study. “However, this traditional method of delivering chemo into the bloodstream can cause the drugs to reach organs such as the liver, kidneys, brain and bone marrow, with less chemo getting to the lungs. This can cause organ damage and in rare cases, death.”

Daw and colleagues are studying the feasibility and safety of delivering the anti-cancer drug gemcitabine through an inhaler – the same type used in asthma treatment. Patients ages 12 to 50 years old who have lung tumors that developed from cancer that originated elsewhere are eligible to participate.

Inhalation chemotherapy, as it is called, was first tested and proven effective in mice in a laboratory study led by Nancy Gordon, M.D., assistant professor of Pediatrics, and Eugenie Kleinerman, M.D., professor of Pediatrics at MD Anderson. Further studies showed the therapy also helped lessen metastasized lung tumors in dogs with osteosarcoma, the most common type of pediatric bone cancer.

The current study targets lung tumors that have developed from all types of solid tumors in children and adults, not just osteosarcoma. Participants are first required to take a pulmonary function test.

“Pulmonary testing is extremely important before any treatment is administered,” says Gordon, the trial’s co-principal investigator. “It lets us know if the patient is well enough to handle the treatment.”

Each treatment lasts 15 to 30 minutes and is given in the hospital twice a week. Treatment duration can last from one month to one year, depending on the patient’s tolerance and tumor response.

Blood samples are collected to measure the amount of drug that may enter into the bloodstream. Lung tumor samples are also collected to evaluate how gemcitabine may have affected the tumor and the immune response in the lungs.

“We hope to find that the inhaled therapy delivers the drug directly to the lungs,” Daw says, “where it will reduce tumors while sparing healthy organs.”