Nitroglycerin as a sensitizer in the treatment of non-small-cell lung cancer: a phase II trial

Info

Location: MAASTRO Clinic, The Netherlands
Collaboration: Prof. Philippe Lambin and Dr. Bart Reymens, investigators
Vivian Braeken, study coordinator

 

Lung cancer is still one of the most common cancer types with non-small cell lung cancer as the most frequently occurring subtype. The treatment of non-small lung cancer is difficult as tumors often do not respond sufficiently to the standardly available treatments. One of the reasons of this insufficient response lies within a lack of oxygen in the tumor. Tumors, due to their rapid growth, often do not have enough time to develop a sufficient blood supply system in the tumor. This causes a lack of oxygen which has proven to be an important factor in the efficacy of radiotherapy, amongst other therapies. Because of this, the cancer cells are less responsive to radiotherapy. A better blood supply in the tumor could increase the oxygen levels in the tumor and sensitize the cancer cells for treatment. One of the drugs that can be used to increase the blood supply in tissues is nitroglycerin.

Nitroglycerin has been available for a long time as a drug to improve the blood flow from the heart after a heart infarction. It is a safe and effective drug with a low risk of side effects. In addition, the drug is not expensive.

Previous research in animals has shown that the use of nitroglycerin can enhance sensitivity to radiation in cancer treatment. In patients affected with lung cancer, the effect of nitroglycerin on radiation therapy has not been studied in depth. If it were shown that nitroglycerin can increase the oxygen levels in the tumor, thereby making the tumor more sensitive to radiotherapy, this could be a safe, effective and low-cost method to improve lung cancer treatment.

To study the effect of nitroglycerin in non-small cell lung cancer, 42 patients have been included in a trial at the MAASTRO clinic. All patients were given nitroglycerin patches during the radiotherapy course. The effect of nitroglycerin on the blood supply in the tumors was measured during two additional CT scans. In addition, the effect of the nitroglycerin on the oxygen levels in the tumor was measured using specific scans, called HX4 scans. These results are currently being analyzed by the research team. In addition, patients are being followed up to evaluate the disease course and see whether nitroglycerin patches can extend patients’ life.

Click here for an informative short film on the study.

Professional info

Location: MAASTRO Clinic, The Netherlands
Collaboration: Prof. Philippe Lambin and Dr. Bart Reymens, investigators
Vivian Braeken, study coordinator

 

Lung cancer is still one of the most common cancer types with non-small cell lung cancer as the most frequently occurring subtype. The treatment of non-small lung cancer is difficult as tumors often do not respond sufficiently on the standardly available treatments. One of the reasons of this insufficient response lies within a lack of oxygen in the tumor. Tumors, due to their rapid growth, often do not have enough time to develop a sufficient blood supply system in the tumor. This causes a lack of oxygen which has proven to be an important factor in the protection of cell damage after radiation. Because of this, the cancer cells are less responsive to radiotherapy. A better blood supply in the tumor could increase the oxygen levels in the tumor and sensitize the cancer cells for treatment. One of the drugs that can be used to increase the blood supply in tissues is nitroglycerin.

Nitroglycerin has been on the market for a long time as a drug to improve the blood flow from the heart after a heart infarction. It is a safe and effective drug with a low level of side effects. In addition, the drug is not expensive.

Previous research in animals has shown that the use of nitroglycerin can enhance sensitivity for radiation and chemotherapy in cancer. In humans, initial positive results with chemotherapy in Japan could not be replicated in 3 other studies conducted in Germany, in the Netherlands, and in Australia and New Zealand. The effect of nitroglycerin on radiation therapy in patients has not been studied in depth. If it was shown that nitroglycerin also improved survival by increasing the chance of eradicating the primary tumor in lung cancer by radiotherapy, this could be a safe, effective and low-cost method to improve lung cancer treatment.

To study the effect of nitroglycerin in non-small cell lung cancer, 42 patients have been included at the MAASTRO clinic. All patients were given nitroglycerin patches during the radiotherapy course. The effect of nitroglycerin on the blood supply in the tumors was measured during two additional CT scans. In addition, the effect of the nitroglycerin on the oxygen levels in the tumor was measured using additional HX4 scans. These results are currently being analyzed by the research team. In addition, patients are being followed up to evaluate the disease course and see whether nitroglycerin patches can prolong survival.

Prof. Philippe Lambin and Dr. Bart Reymens are the investigators of this trial. More details about this study (NCT01210378) at www.clinicaltrials.gov.

Click here for an informative short film on the study.