Sept. 20--Terry Lentsch decided he'd had enough of chemotherapy. Three rounds of the stuff in 18 months wore him out, and his stage IV lung cancer was no better. In fact, it seemed to have spread to his left lung, his spine and lymph nodes.
It was time to quit.
"I told myself, 'I'm not going through the harshness of chemo anymore if it's not doing any good,'" said Lentsch, a 59-year-old nonsmoker.
"I'm sorry, Terry," his doctor in Colorado Springs responded after the third round of chemo ended in August 2009. "I have nothing left to throw at this."
But the doctor did offer one suggestion to Lentsch: Contact the University of Colorado Cancer Center in Aurora to see if there might be some clinical trials going on.
Skeptical but willing, Lentsch checked it out, and in late 2009, he became a guinea pig for a new drug from Pfizer. As he closes in on a year's treatment, his doctor tells him there's no "measurable" mass in his right lung, and the other tumors cleared up not long after he began taking his six pills a day.
"Most everything that was there is not there anymore," Lentsch said.
Since the trial began in 2008, researchers have seen similarly spectacular results in about 90 of the 100 patients in the trial, with few side effects aside from mild diarrhea or constipation.
Researchers in Denver are still soliciting patients for treatment. The only problem is, the drug is not a one-size-fits-all lung cancer treatment. It takes aim at a protein called ALK, and only about 5 percent of all lung cancers are ALK-positive. Dr. Ross Camidge, director of the lung cancer clinical program at UC-Denver, said people newly diagnosed with lung cancer would be wise to get tested to see if they are ALK-positive, then contact the university about treatment. The university also tests for ALK.
"Every year in the U.S., 200,000 people are diagnosed with lung cancer. We predict that about 10,000 of them will be ALK-positive," Camidge said. "Now, we're two years into the study, so during that two-year period, you would expect 20,000 people to be ALK-positive. That's 9,900 people out there who haven't been tested and don't know they're ALK-positive, so getting people tested is the No. 1 priority."
Targeting cancer down to the molecular level is the frontier of cancer research, the idea being that cancers are made up of a variety of cells. In this case, the drug targets ALK, and appears to do it very well.
"About 90 percent of people will benefit from the drug if they're ALK-positive, and the benefit can be to the point where the scans will even be normal, so the cancer actually disappears," Camidge said.
But the cancer isn't gone, Camidge warns, and the drug isn't a cure. Over time, different types of cells not affected by the drug will take over.
"You introduce natural selection," he said. "They will become the dominant cells in the cancer. It means the cancer that grows back will be subtly different than the cancer you started with."
Just how long Pfizer's new drug will control ALK-type lung cancer has yet to be determined, but Camidge said the hope is that it will be long enough so researchers can come up with newer, better drugs.
"These people are walking across a bridge that hasn't been finished," Camidge said. "We're hoping to walk slow enough that the builders can continue to build the bridge right under their feet."
For the time being, though, ALK-positive patients are coming to Denver from such far-flung places as Seattle and Johannesburg, and almost all are reporting amazing results.
"It's slightly odd to be a lung cancer doctor, and the patient comes in and says, 'I just won a tennis tournament,' or 'I just climbed a fourteener,'" Camidge said. "They get a new lease on life."
Lentsch, an avid nature photographer and outdoorsman, is back to hiking, though he hasn't tackled another fourteener since his lung cancer diagnosis.
"But I've still been hiking to (12,000 feet elevation) to see mountain lakes and get the scenery," said Lentsch, facilities manager at a Christian publishing company. "I have to take it slow, and I huff and puff on the steep slopes, but I've gotten there."
Lentsch thinks back to his decision to go to Denver for the clinical trial, in spite of his pledge to himself not to take on more treatment.
The weekend before his appointment, he says he prayed: "God, I need a miracle here if anything's going to change." A few days later in Denver, he met a patient who was already undergoing treatment.
"This is a miracle drug," she told him.
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