Lung Cancer Drugs Tarceva and Iressa May Offer More Benefit
A small study has found that lung-cancer drug Tarceva (erlotinib) may lengthen survival in patients with non–small-cell lung cancer after first- or second-line chemotherapy. Researchers involved in the study, published in the New England Journal of Medicine (NEJM), are not sure how the drug works, and disagreement exists over how to predict which patients will benefit most from Tarceva.
Tarceva has been approved by the US Federal Drug Administration (FDA) to treat people who have advanced, non–small-cell lung cancer and who have already undergone chemotherapy.
Lung cancer is the second most common type of cancer, and the most common cause of cancer-related deaths in men and women in the United States, according to the National Cancer Institute.
Previous studies reported that genetic mutations in about 10% of the target patient population made these patients more responsive to Tarceva and Iressa (gefitinib), a related chemotherapy drug. Tumors in these patients shrank by about 50%. However, the more recent study suggests that testing based on these genetic mutations may not be as useful as previously believed.
The international study, led by the National Cancer Institute of Canada and published in the NEJM, included 731 patients and concluded that, while the genetic mutations might help to predict responsiveness to the drugs, it did not help to predict which patients would live longer.
The study concluded that the patient-groups who were most likely to benefit from taking erlotinib were patients with adenocarcinoma (a type of tumor), women, non-smokers and Asians.
Researcher Frances A. Shepherd believes that doctors could consider prescribing Tarceva to all eligible patients, without waiting for genetic test-results, according to a report in USA Today published July 13. Some experts believe the study had weaknesses, including the fact that, because of the invasive nature of taking slices of long-tumor, researchers examined lung tissue from less than half of patients, and analyzed tissue for mutations in about 25% of study participants.
The report also noted that the study’s small patient-pool may have affected outcomes, and it is still unknown whether other, as-yet-unidentified genes and proteins may affect patients’ response to these drugs.
Additional research, preferably with a larger patient population, would offer insight into these controversial points and perhaps illuminate the mechanism by which these drugs work.
Sources:
Study: Lung Cancer Drugs May Help More, Washington Post,
July 13, 2005.
Drug
extends lung cancer patients’ survival, USA Today,
July 13, 2005.
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