Tarceva and chemotherapy offer no advantage in lung cancer treatment except for group of non-smokers

06/04/04

NEW ORLEANS - The University of Texas M. D. Anderson Cancer Center offers these news items presented at the annual meeting of the American Society of Clinical Oncology meeting.

A large Phase III clinical trial of an EGFR inhibitor, Tarceva(tm), used in combination with chemotherapy to treat advanced lung cancer, did not show a survival advantage, but hinted that young non-smokers did benefit from the targeted therapy.

The results are similar to a clinical trial that tested a targeted therapy nearly identical in structure and function, Iressa, which was approved for use in 2003 based on evidence that the drug was best used for some non-smokers who developed lung cancer, says Roy Herbst, M.D., Ph.D., from M. D. Anderson Cancer Center.

Herbst, an associate professor in the Department of Thoracic/Head and Neck Medical Oncology, has tested both drugs and led this latest trial.

"I think we know now that this class of drug does not function well when combined with chemotherapy," Herbst says. "That may be because the drug stops cells from growing, but that also makes them less sensitive to chemotherapy."

Tarceva (also known as OSI-774 or Erlotinib) inhibits a receptor on cancer cells for a protein called the epidermal growth factor (EGF), which helps spur cells to divide. Many types of cancer cells tend to produce too much EGF.

In the 1,059-patient double-blind, randomized trial, known as TRIBUTE, Tarceva used with chemotherapy was compared to treatment with chemotherapy and a placebo. The trial showed the safety of Tarceva, but did not show an overall benefit in survival or response between the groups.

Still, Herbst said a "bright spot" in the study was a sub-analysis, performed by researchers at the Memorial Sloan-Kettering Cancer Center that showed 69 young non-smokers treated with Tarceva survived 23 months versus 10 months for a group of 44 similar patients who used chemotherapy and a placebo drug. "There seemed to be a maintenance effect of Tarceva in patients who responded or had stable disease after chemotherapy," Herbst says, adding that "Tarceva deserves further study in those patients whose disease stabilizes or responds after chemotherapy treatment for non-small cell lung cancer."

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