Science Current Events | Science News | Brightsurf.com
 

New analysis helps guide use of erlotinib in advanced non-small cell lung cancer

April 18, 2012
Patients with advanced non-small cell lung cancer should only receive treatment with the drug erlotinib before receiving standard chemotherapy if their tumor is known to harbor EGFR mutations, researchers report at the 3rd European Lung Cancer Conference in Geneva, Switzerland.

The results of biomarker analyses of a recently reported clinical trial confirm that patients with unknown or negative mutation status should be treated with the standard chemotherapy first, they say.

The TORCH trial was a randomized phase III trial conducted in Italy and Canada, which compared the efficacy of treatment with erlotinib, followed at progression of disease by cisplatin and gemcitabine, against the standard reverse sequence. Erlotinib is a drug that specifically targets the epidermal growth factor receptor (EGFR) tyrosine kinase.

The primary endpoint of the original TORCH study was overall survival and 900 patients were planned, however the study was stopped early as the first interim analysis showed that the erlotinib-first regimen was inferior to the standard approach.

In the new study, Dr Ming Tsao and colleagues conducted an exploratory analysis on the TORCH patient tumor samples that were available for analysis, looking for molecular biomarkers known to be potential predictors of benefit from EGFR inhibitors.

"Our results show a significant interaction in progression-free survival favoring treatment with erlotinib first in EGFR-mutated patients, and favouring first treatment with chemotherapy in EGFR wild type [non-mutated] patients," said Dr Tsao, from the Princess Margaret Hospital.

"However there was no significant interaction between treatment efficacy and overall survival. This shows that using erlotinib to treat patients with a mutated tumor is always effective, both in first and in second line; of course, it is much more convenient for these patients to receive it as first line, as shown also in other trials," Dr Tsao said.

Patients with EGFR mutations benefit from the erlotinib-first regimen because their tumors are very sensitive to the anti-tumor activity of the drug, he explained.

"The take-home message from this study is that in advanced non-small cell lung cancer patients, treatment with erlotinib first should only be applied to patients whose tumor is known to harbor EGFR mutation," said Dr Tsao. "Patients with unknown or negative mutation status should be treated with the standard chemotherapy first."

Commenting on the study which he was not involved in, Dr Tetsuya Mitsudomi from Aichi Cancer Center Hospital in Nagoya, Japan, member of the IASLC Board of Directors, said: "Many previous trials, for instance IPASS, NEJ002, WJTOG3405, OPTIMAL, EUROTAC, have already shown that EGFR mutation is the most reliable predictive marker for EGFR-TKI treatment. The current paper was able to confirm the importance of EGFR mutation testing when considering the use of erlotinib, especially in consideration of the far shorter progression-free survival obtained with erlotinib when the mutation was absent. Consequently, although it was thought that erlotinib is active even in lung cancer patients without EGFR mutation if compared with gefitinib, this study suggests that erlotinib should be avoided when treating patients without EGFR mutation, at least in the first-line setting."

This biomarker analysis was preplanned but actually only 36% of the samples could be anlayzed for EGFR mutation. This relatively low tissue accrual rate is precedented by many clinical trials in which the mutation analysis was performed retrospectively. "Therefore, we also have to consider prospective determination of oncogene mutation when we want to raise this rate such as in NEJ, WJTOG, OPTIMAL and EUROTAC," Dr Mitsudomi added.

"In summary, the TORCH-BIO study adds imprortant evidence to the research field of EGFR-TKI in lung cancer and emphazizes the importance of biomarker study for improvement of clinical outcome."

European Society for Medical Oncology


Related Erlotinib Current Events and Erlotinib News Articles


Drug-Target Database Lets Researchers Match Old Drugs to New Uses
There are thousands of drugs that silence many thousands of cancer-causing genetic abnormalities.

Chemotherapy timing is key to success
MIT researchers have devised a novel cancer treatment that destroys tumor cells by first disarming their defenses, then hitting them with a lethal dose of DNA damage.

Cancer stem cells linked to drug resistance
Most drugs used to treat lung, breast and pancreatic cancers also promote drug-resistance and ultimately spur tumor growth.

Immunotherapy data heralds new era of lung cancer treatment
A new era of lung cancer therapy is close to dawning, using drugs that can prevent tumour cells from evading the immune system, experts have said at the 4th European Lung Cancer Congress.

Targeted drug may prolong survival of patients with cervical cancer
A new clinical study has found that erlotinib, a targeted antitumor agent, has promising potential to improve treatment for cervical cancer.

Afatinib: added benefit depends on mutation status
Afatinib (trade name: GIOTRIF) has been approved in Germany since September 2013 for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with activating EGF receptor mutations who have not been treated with an EGF receptor tyrosine-kinase inhibitor (EGFR TKI).

In search of a treatment for a rare bone cancer
Johns Hopkins researchers say that a drug approved to treat lung cancer substantially shrank tumors in mice that were caused by a rare form of bone cancer called chordoma.

Potential new drug for some patients with treatment-resistant lung cancer
The investigational drug AZD9291, a third-generation EGFR inhibitor, showed promise in preclinical studies and provides hope for patients with advanced lung cancers that have become resistant to existing EGFR inhibitors.

Molecular marker predicts patients most likely to benefit longest from 2 popular cancer drugs
Johns Hopkins scientists have identified a molecular marker called "Mig 6" that appears to accurately predict longer survival -- up to two years -- among patients prescribed two of the most widely used drugs in a class of anticancer agents called EGFR inhibitors.

Gene signature can predict who will survive chemotherapy
An eight gene 'signature' can predict length of relapse-free survival after chemotherapy, finds new research in Biomed Central's open access journal BMC Medicine.
More Erlotinib Current Events and Erlotinib News Articles

Management and Mechanisms of gained erlotinib-resistance in NSCLC.

Management and Mechanisms of gained erlotinib-resistance in NSCLC.
by Nichole C Farneth (Author)


Enjoy a wide range of dissertations and theses published from graduate schools and universities from around the world. Covering a wide range of academic topics, we are happy to increase overall global access to these works and make them available outside of traditional academic databases. These works are packaged and produced by BiblioLabs under license by ProQuest UMI. The description for these dissertations was produced by BiblioLabs and is in no way affiliated with, in connection with, or representative of the abstract meta-data associated with the dissertations published by ProQuest UMI. If you have any questions relating to this particular dissertation, you may contact BiblioLabs directly.

Erlotinib: Webster's Timeline History, 2003 - 2007

Erlotinib: Webster's Timeline History, 2003 - 2007
by Icon Group International (Author)


Webster's bibliographic and event-based timelines are comprehensive in scope, covering virtually all topics, geographic locations and people. They do so from a linguistic point of view, and in the case of this book, the focus is on "Erlotinib," including when used in literature (e.g. all authors that might have Erlotinib in their name). As such, this book represents the largest compilation of timeline events associated with Erlotinib when it is used in proper noun form. Webster's timelines cover bibliographic citations, patented inventions, as well as non-conventional and alternative meanings which capture ambiguities in usage. These furthermore cover all parts of speech (possessive, institutional usage, geographic usage) and contexts, including pop culture, the arts, social sciences...

  Erlotinib, gefitinib nip lung cancer mortality.(Pulmonary Medicine): An article from: Internal Medicine News
by Erik L. Goldman (Author)


This digital document is an article from Internal Medicine News, published by International Medical News Group on September 1, 2004. The length of the article is 609 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.

Citation Details
Title: Erlotinib, gefitinib nip lung cancer mortality.(Pulmonary Medicine)
Author: Erik L. Goldman
Publication: Internal Medicine News (Magazine/Journal)
Date: September 1, 2004
Publisher: International Medical News Group
Volume: 37 Issue: 17 Page: 24(1)

Distributed by Thomson...

Molecular Oncology: Causes of Cancer and Targets for Treatment

Molecular Oncology: Causes of Cancer and Targets for Treatment
by Edward P. Gelmann (Editor), Charles L. Sawyers MD (Editor), Frank J. Rauscher III (Editor)


The genomic era has allowed enormous strides in our understanding of the molecular changes that underlie malignant transformation. Mutations have been discovered that are critical drivers of large cross-sections of human cancers. These discoveries have allowed us to find drugs that target these drivers and make important strides in treatment. Genomics and high-throughput technologies have illuminated the complexity of cancer and the facility with which cancers adapt during their natural history. The field is evolving rapidly with new discoveries and new drugs reported monthly. This book is a timely foundation for understanding in context the origins of molecular oncology and its future directions. The content reviews available technologies for the analysis of cancer tissues and genes;...

  Erlotinib: An entry from Thomson Gale's Gale Encyclopedia of Cancer, 2nd ed.
by Tish, A. M. Davidson (Author)


Students, researchers, and patients can find reliable, up-to-date and clearly written information in “The Gale Encyclopedia of Cancer,” a comprehensive survey of 120 cancers, cancer drugs, traditional and alternative treatments and diagnostic procedures.

The Top 100 Drug Interactions: A Guide to Patient Management (Hansten, Top 100 Drug Interactions)

The Top 100 Drug Interactions: A Guide to Patient Management (Hansten, Top 100 Drug Interactions)
by Philip D. Hansten (Author), John R. Horn (Author)


This is the 15th yearly edition of The Top 100 Drug Interactions, with more than 300,000 copies in print since the first edition was published in 2000. In this book the authors attempt to identify drug interactions that should not be ignored in clinical practice. Management options are given for each interaction to offer the clinician actions that may be taken to reduce the risk of an adverse outcome. The book also contains a clinically useful and comprehensive table of drugs that are substrates, inhibitors or inducers of cytochrome P450 isozymes and ABC transporters.

Devita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology Review (Cancer: Principles & Practice (DeVita)(Single Vol.))

Devita, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology Review (Cancer: Principles & Practice (DeVita)(Single Vol.))
by Ramaswamy Govindan MD (Author)


Ace the oncology boards with the field’s most comprehensive self-paced review! Based on DeVita, Lawrence, and Rosenberg's Cancer: Principles & Practice of Oncology, Ninth Edition, this in-depth question-and-answer review and workbook covers the entire specialty of oncology and provides thorough preparation for oncology boards.

Inside, readers will discover hundreds of multiple-choice and case-based questions covering the principles of surgical oncology, radiation oncology, medical oncology, and hematology/oncology and the biology, diagnosis, staging, and multimodality treatment of cancers at every anatomic site. Included are state-of-the-art chapters on molecular techniques, targeted therapies, and current approaches to cancer prevention.

Detailed answers and explanations...

  Bevacizumab-erlotinib combo boosts lung cancer survival.(Pulmonary Medicine)(cancer medicine): An article from: Family Practice News
by Jane Salodof MacNeil (Author)


This digital document is an article from Family Practice News, published by Thomson Gale on September 1, 2006. The length of the article is 713 words. The page length shown above is based on a typical 300-word page. The article is delivered in HTML format and is available in your Amazon.com Digital Locker immediately after purchase. You can view it with any web browser.

Citation Details
Title: Bevacizumab-erlotinib combo boosts lung cancer survival.(Pulmonary Medicine)(cancer medicine)
Author: Jane Salodof MacNeil
Publication: Family Practice News (Magazine/Journal)
Date: September 1, 2006
Publisher: Thomson Gale
Volume: 36 Issue: 17 Page: 43(1)

Distributed by Thomson...

Pocket Guide To Chemotherapy Protocols

Pocket Guide To Chemotherapy Protocols
by Edward Chu (Author)


Newly updated for 2012, the Pocket Guide to Chemotherapy Protocols, Seventh Edition, is a spiral-bound quick-reference guide arranged alphabetically by cancer type. This handy, practical pocket guide contains combination, as well as selected single-agent regimens for solid tumor and hematologic malignancies. In each case, the regimens selected are based on published literature and are used in clinical practice in the medical oncology community. The Seventh Edition of the bestselling pocket guide is completely revised and updated and continues the success of previous editions by offering cancer care professionals complete, authoritative information in a convenient format. Pocket Guide to Chemotherapy Protocols is a must-have quick reference guide for physicians, nurses, and other health...

Principles and Practice of Lung Cancer: The Official Reference Text of the International Association for the Study of Lung Cancer (IASLC)

Principles and Practice of Lung Cancer: The Official Reference Text of the International Association for the Study of Lung Cancer (IASLC)
by Harvey I. Pass MD (Editor), David P. Carbone MD PhD (Editor), David H. Johnson MD (Editor), John D. Minna MD (Editor), Giorgio V. Scagliotti MD (Editor), Andrew T. Turrisi III MD (Editor)


Thoroughly revised and updated, this Fourth Edition is the most comprehensive, current reference on lung cancer, with contributions from the world's foremost surgeons, radiation oncologists, medical oncologists, pulmonologists, and basic scientists. Coverage includes complete information on combined modality treatments for small cell and non-small cell lung cancer and on complications of treatment and management of metastases. Emphasis is also given to early detection, screening, prevention, and new imaging techniques. This edition has expanded thoracic oncology chapters including thymus, mesothelioma, and mediastinal tumors, more detailed discussion of targeted agents, and state-of-the-art information on newer techniques in radiotherapy. Other highlights include more international...

© 2014 BrightSurf.com