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Tarceva as a Single-Agent Provides Responses in Advanced Lung Cancer

The use of the targeted agent Tarceva (erlotinib) as a single agent appears to provide durable anti-cancer responses among patients with EGFR-positive lung cancer with cancer spread to the brain. These results were recently published in the Annals of Oncology.

Lung cancer remains the leading cause of cancer-related deaths in the United States and worldwide. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer and refers to the type of cell within the lung from which the cancer originated.

Treatment options for patients who have advanced disease and have stopped responding to prior therapies remain limited. Fortunately, some targeted therapies are available for specific types of lung cancers.

Tarceva is an agent that is targeted against the epidermal growth factor receptor (EGFR). The EGFR is a cellular pathway that is involved in normal cellular replication and growth. However, some types of lung cancers have mutations or increased numbers of proteins associated with EGFR. These cancers are referred to as EGFR-positive, and they tend to have increased growth and spread of the cancer associated with the EGFR pathway.

Tarceva is an agent that selectively binds to specific proteins of the EGFR. This binding halts the progression of spread of cancer cells associated with the abnormal EGFR. Furthermore, side effects associated with Tarceva tend to be less severe than those associated with chemotherapy. Researchers continue to explore optimal ways in which to use Tarceva therapeutically.

Researchers from China recently conducted a clinical trial to evaluate the efficacy and safety of Tarceva among 48 patients with NSCLC. Patients had cancer spread to the brain (brain metastases) and had received prior therapy.

Survival with no progression of cancer (progression-free survival) was significantly longer among patients with EGFR-positive NSCLC (15.2 months) versus those without the mutations (4.4 months).
Survival at 6 months was 85% and survival at one year was 73%.
The most common side effect was rash.
The researchers concluded that treatment with Tarceva alone provided long-lasting anti-cancer responses among patients with NSCLC and brain metastases, particularly among those with EGFR mutations. The authors stated that “Further studies are warranted” for this treatment approach in this group of patients.

Reference: Wu Y-L, Zhou C, Cheng Y, et al. Erlotinib as second-line treatment in patients with advanced non-small-cell lung cancer and asymptomatic brain metastases: a phase II study (CTONG–0803). Annals of Oncology. 2013; 24(4): 993-999.