Navigation Links
New analysis helps guide use of erlotinib in advanced non-small cell lung cancer
Date:4/18/2012

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 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."


'/>"/>

Contact: Vanessa Pavinato
media@esmo.org
European Society for Medical Oncology
Source:Eurekalert

Related biology news :

1. On the safe side: Contact-free analysis of chemical substances
2. Fine-scale analysis of the human brain yields insight into its distinctive composition
3. Buy coal? New analysis shows purchasing fossil fuel deposits best way to fight climate change
4. Analysis of stickleback genome sequence catches evolution in action
5. A new application allows online statistical analysis of gene-expression data
6. New analysis of premature infants heartbeats, breathing could be cues for leaving NICU
7. Beyond the microscope: Identifying specific cancers using molecular analysis
8. Analysis of generalized linear mixed models
9. Psychemedics Awarded Patent Fundamental To Hair Analysis Drug Testing
10. Sweeping genetic analysis of rare disease yields common mechanism of hypertension
11. Elusive ultrafine indoor air contaminants yield to NIST analysis
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:1/28/2016)... 2016 Synaptics (NASDAQ: SYNA ), a leading developer ... quarter ended December 31, 2015. --> ... 2016 increased 2 percent compared to the comparable quarter last year ... 2016 was $35.0 million, or $0.93 per diluted share. ... the first quarter of fiscal 2016 grew 9 percent over the ...
(Date:1/25/2016)... , Jan. 25, 2016  Glencoe Software, the world-leading ... and publication industries, will provide the data management solution ... (NPSC). ... Phenotypic analysis measures the ... organisms, allowing comparisons between states such as health and ...
(Date:1/21/2016)... India , January 21, 2016 ... According to a new market research report "Emotion Detection ... and Others), Software Tools (Facial Expression, Voice Recognition ... Regions - Global forecast to 2020", published by ... is expected to reach USD 22.65 Billion by ...
Breaking Biology News(10 mins):
(Date:2/11/2016)... ... February 11, 2016 , ... ... announced a new agreement with Bankok,Thailand-based Global Stem Cells Network (GSCN) to distribute ... 15 Latin American countries, including Mexico, Costa Rica, Dominican Republic, Colombia, Argentina, Nicaragua, ...
(Date:2/10/2016)... , Feb. 10, 2016 NX Prenatal Inc., ... proprietary NeXosome® technology for early warning of adverse ... most recent study by Dr. Thomas McElrath ... Society for Maternal Fetal Medicine,s (SMFM) annual meeting held ... th , 2016.  The presentation reported initial positive ...
(Date:2/10/2016)... -- Matchbook, Inc., a company specializing in procurement and ... today the appointment of Jim Shuman ... 25 years of experience in supply chain, logistics ... decades in executive level roles as the SVP ... most recently headed global logistics and procurement at ...
(Date:2/10/2016)... ... February 10, 2016 , ... PatientCrossroads ... on the secure online PatientCrossroads platform, has exceeded both its one-year and overall ... the PROMPT study, which seeks to advance understanding of the hereditary risks for ...
Breaking Biology Technology: