Right now, doctors have no way of knowing who will or won't be helped by more aggressive therapies. The project was funded by a grant from the Duke Thoracic Oncology Program. While physicians have traditionally used only surgery to treat the cancer, clinical trials are under way using chemotherapy and radiation therapy before surgery. The Duke researchers, however, suspect that the patient group studied was too undifferentiated. By studying patients' tumors on a molecular level, they are seeking to identify a subset of patients who are more likely to benefit from the aggressive tri-modality therapy.
Most tumor cells have different genes and proteins activated compared to normal cells.
In some cases tumors express genes that normal cells don't, and in others the tumors lack genes normally expressed. A third option is for a gene to be altered, or mutated, in a way that scientists can detect. All of these changes are reflected in the presence, lack or mutation of the genes' product proteins. By examining the pattern of these genetic alterations, Harpole said he hopes to provide a more detailed picture of tumors to eventually predict patients' responses to treatment. The ultimate goal is to tailor therapy and improve survival.