Meeting Summary

The first SOTS meeting on lung cancer focused on the search for molecular targets for use in small-cell lung cancer therapy. Speakers on molecular genetics provided an update on progress made in identifying key genetic mutations relevant to small-cell lung cancer treatment, and considered the genetics of nicotine addiction. The primacy of receptors as potential targets was emphasized, and multiple downstream targets proposed. Discussions on immunotherapy covered progress made in optimizing T cell response against tumor cells and reviewed vaccination efficacy in chemotherapy recipients. Discoveries in anti-angiogenic therapy were also reviewed, including their impact on cytotoxic efficacy and the importance of tumor burden. Panelists discussed ways of addressing limited tissue resources, including developing research models to overcome logistical difficulties in obtaining serial biopsies, employing antibodies to facilitate examination of signal pathways in archival tissues, creating a tissue registry, and pushing development of new cell lines. The latter's significance was stressed given the mounting evidence for cell-specificity of signal transduction. Study design topics included use of circulating tumor cell markers as intermediate endpoints; implementation of multi-modality trials as opposed to sequential phase I trials testing individual agents (some of which may be only cytostatic); patient selection based on immunohistochemical profiling; and design of randomized phase II trials to expedite transition to phase III. Increased emphasis was urged on biological effect in phase I trials and clinically applicable endpoints in phase III trials.