Abstract
Currently, lung cancer treatment has been developing in several approaches such as; conservative chemotherapy or novel targeted therapies which increase the overall response rate, survival rate with good quality of life for the patients. Thus this research project’s goal is to explore the molecular alterations in Thai lung cancer patients which could be different from the other ethnicities. The result of this research will lead to targeted drug development in Thailand for Thai lung cancer patients which the investigators will co-operate with ECDD (Excellence Center of Drug Discovery). This center was established in July 2016 by the co-operation and commitment between Faculty of Science, Mahidol University and Faculty of Medicine Ramathibodi Hospital, Mahidol University. The preliminary result of molecular alterations in 56 Thai lung cancer patients from this research project by NGS method from both FFPE and fresh frozen tumor tissue (initial analyzed only the common mutations in lung cancer) showed EGFR mutation 39%,
BRAF mutation 13%, KRAS mutation 20%, and MET mutation 2%. We also found 9 patients (16%) whom had more than one mutation. These preliminary results were very interesting and different from the other countries’ results, but we need to wait for the further analysis in larger sample size including deeper analysis for novel and uncommon mutations in Thai lung cancer patients in the second and third year for this research project. Even though we explore the diagnostic technique and the approach for lung cancer treatment as mentioned above, but the cancer prevention is also very important for the oncology world right now. The previous literatures reported the role of Metformin (anti-diabetic drug), Aspirin (anti-platelet drug), and Statins (lipid lowering agents) in decreasing cancer incidence rate, but the results were not homogenous and most of studies were small population based studies only. These 3 groups of drug involve in the metabolism of human body, thus cancer metabolism is the important and interesting field which could
lead to cancer prevention in the future. This research project also focuses in cancer metabolism and cancer prevention by studying the largest and longest follow-up of population based study in Thailand (EGAT database: Electricity Generating Authority of Thailand). The preliminary results showed Statins had statistically significant decreased the cancer incidence rate with the hazard ratio of 0.42 (P <0.001). Aspirin and Metformin also had the trend of lowering the cancer incidence rate but they were not statistically significant. Although this report is only the initial result, but it is very interesting and
fascinating to explore more in term of cancer prevention and wait for the deeper analysis in the next report. In conclusion, the study of molecular alterations in Thai lung cancer patients is very important for targeted drug development in order to drive the innovative lung cancer treatment. However, the other important issue and concern is cancer prevention. Nowadays cancer is the most leading cause of death in Thailand and cancer also causes a lot of burdens in Thailand and Global public health. We believe that cancer metabolism is one of the key factors for cancer prevention in the future which could probably help to prevent and decrease the cancer incidence rate and solve the cancer burden in Thailand.
