Lugano-CH/Aurora-US-CO/Geneva-CH, 18 April 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 re
|Contact: Vanessa Pavinato|
European Society for Medical Oncology