Dr. Allen Fremont considers himself a lucky guy. Fremont, a researcher at the RAND Corporation, was diagnosed with stage IV non-small cell lung cancer in 2011 at a Los Angeles hospital and given a poor prognosis. Chemotherapy at a Los Angeles-area hospital had shrunk the tumors by 30 percent, but the cancer was still there.
"I thought that was it," says Fremont, MD, PhD, a physician and researcher at the RAND Corporation in Santa Monica, who is married and has two children. A non-smoker, he had felt healthy until he developed a persistent cough. "For people with the kind of cancer I had, the game was over. My horizon was six months to a year out."
But he found his way to Dr. Sai-Hong Ignatius Ou, a UC Irvine Health oncologist, who was conducting a clinical trial for a drug called crizotinib aimed at non-small cell lung cancer in patients with a particular genetic mutation called ROS1.
Today, three years later, Fremont's cancer is in remission.
Impact of clinical trials
The trial drug received FDA approval and is marketed under the Pfizer brand name, Xalkori. "I can't overstate the importance of what they're doing at UC Irvine, being part of this clinical trials network," says Fremont, a father of two.
Ou is the first co-author of a recent New England Journal of Medicine article citing a 72 percent response rate to crizotinib in patients like Fremont.
Lung cancer is the leading cause of cancer death in the United States. However, UC Irvine Health — the only National Cancer Institute-designated comprehensive cancer center in Orange County — is using targeted medications for lung cancer and for many other aspects of lung cancer treatment and diagnosis.
Ou was a clinical investigator for a study that evaluated crizotinib in lung cancer patients with another type of genetic mutation called ALK. That trial showed people on crizotinib had more than double the survival rate compared to people on chemotherapy only. The paper was published in 2010 in the prestigious New England Journal of Medicine.
Ou is the first co-author of another NEJM study, published online on Sept. 27, 2014, showing 72 percent of patients with advanced non-small cell lung cancer and the ROS1 mutation responded to crizotinib. The median response time was 19 months, a landmark in lung cancer.
"The impact of crizotinib is proof of the principle that even if a mutation is rare, if you find it and give people the right drug for the right target, you will make a difference—and not only in lung cancer. The ROS1 mutation is found in colon, stomach, brain and gallbladder cancers," Ou says.
Other targeted therapies
Several clinical trials are underway at UC Irvine Health using targeted therapies on cancers caused by other mutations, such as the NTRK mutation found in some lung, colon and breast cancers, he says. "We were four years ahead of everyone in looking at ROS1," Ou says.
"We have clinical trials here that other people may not have." In all, UC Irvine Health has more than 150 clinical trials are underway across all types of cancers. View our cancer clinical trials ›
"I can't overstate the importance of what they're doing at UC Irvine, being part of this clinical trials network,” says Fremont. It has become a model for other types of breakthroughs in cancer."
For Fremont, treatment at UC Irvine Health has meant putting the cancer experience behind.
"Once we started to see the response to the medication and that the cancer wasn't coming back, we started to plan vacations six months out or a year out," Fremont says. "I got to be there for my son's bar mitzvah, which was amazing. I got to travel with my mom and dad to Europe to see where my dad lived during World War II, which was incredibly meaningful. I'm living a full and complete life."