Erlotinib improves progression-free survival as first-line therapy in advanced lung cancer

October 09, 2010

For patients with advanced lung cancer whose tumors carry EGFR activating mutations, first-line treatment with erlotinib nearly tripled progression-free survival compared to a standard chemotherapy combination, show results from the first prospective Phase-III study to report findings in this setting.

The new results from the OPTIMAL trial were reported at the 35th Congress of the European Society for Medical Oncology (ESMO) in Milan, Italy.

"Erlotinib is very effective and well tolerated in advanced NSCLC patients who harbor EGFR activating mutations. It is 2 to 3 times more effective than doublet chemotherapy," said study leader Professor Caicun Zhou of Shanghai Pulmonary Hospital, Tongji University, China.

The OPTIMAL study included 165 patients whose lung cancer carried mutations activating the Epithelial Growth Factor Receptor (EGFR). Participants had not received systemic treatment for their cancer.

Of these patients, 83 were randomly assigned to receive erlotinib 150 mg/day, and 82 patients were assigned to receive a 'doublet' combination chemotherapy of gemcitabine and carboplatin. The primary endpoint of the study was progression-free survival.

In his presentation at the ESMO Congress, Prof Zhou reported that the median progression-free survival in the erlotinib arm was 13.1 months, compared to 4.6 months for the chemotherapy arm of the study. The objective response rate with erlotinib was 83%, compared to 36% for gemcitabine plus carboplatin. 31 patients in the erlotinib arm are still under study and progression free compared to only 1 in the chemotherapy arm.

"OPTIMAL is the first reported prospective Phase-III study to confirm the role of erlotinib in advanced NSCLC patients with EGFR activating mutations," Prof Zhou said. "It does much better than the standard doublet chemotherapy and so we should start erlotinib treatment as soon as possible after the diagnosis of advanced NSCLC with EGFR activating mutations," he added.

Safety analyses showed lower rates of adverse events with erlotinib than with chemotherapy, the researchers report.

Also at the ESMO Congress, Professor Yi-long Wu from Guangdong General Hospital (GGH) & Guangdong Academy of Medical Sciences in China reported the first biomarker results from the study. This analysis aimed to evaluate the impact on various biomarkers with survival among the patient population.

"Detailed biomarker analysis did not identify additional markers that could be used to further optimize treatment decisions. It was found that patients who had exon 19 deletions in EGFR had longer progression-free survival with erlotinib than those with L858R mutations and only one patient had an EGFR T790M mutation, and remained progression-free for only 0.62 months," Prof Wu said.

The results of the OPTIMAL trial have implications for clinical practice, commented Dr Federico Cappuzzo, Director of Medical Oncology at Ospedale Civile in Livorno, Italy.

"These data, combined with data coming from another four large Phase-III studies comparing chemotherapy versus gefitinib, another orally available EGFR tyrosine kinase inhibitor (EGFR-TKI), confirmed that erlotinib or gefitinib represent the best therapeutical option we can offer today as front-line therapy in metastatic NSCLC with activating EGFR mutations."

Dr Cappuzzo noted that all studies so far in this setting have been conducted in Asian populations. A confirmatory study in Caucasian patients is currently ongoing.
-end-


European Society for Medical Oncology

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.