The place of targeted therapy in the patient management of non-small cell lung cancer.
AffiliationDepartment of Medical Oncology, Christie Hospital NHS Trust, Wilmslow Road, Manchester M204BX, UK. Nick.Thatcher2@christie.nhs.uk
MetadataShow full item record
AbstractThere is much interest in the use of targeted therapies for the management of non-small cell lung cancer (NSCLC). To date, four targeted therapies - bevacizumab, cetuximab, erlotinib and gefitinib - have been investigated in randomised trials, in the treatment of advanced NSCLC. In the first-line setting, bevacizumab has been shown to significantly prolong survival when added to carboplatin/paclitaxel, as demonstrated in a large phase III study. However, issues of toxicity limit this treatment regimen to selected patients. The addition of bevacizumab to gemcitabine/cisplatin will be reported at ASCO 2007. The addition of cetuximab to cisplatin/vinorelbine has also been shown to improve survival in a randomised phase II study. Erlotinib has been investigated as monotherapy in first-line chemo-naïve patients and has demonstrated objective response rates of 10-23%. However, in a study comparing erlotinib versus chemotherapy, the outcome was less favourable for patients who had received erlotinib. Erlotinib monotherapy has also been investigated in recurrent disease, and has been shown to improve overall survival over that achieved with placebo. The greatest benefit was observed in never-smokers with epidermal growth factor receptor-positive tumours. In a further phase II randomised study, the effect of combining two targeted therapies has been investigated. This study compared erlotinib/bevacizumab versus bevacizumab/chemotherapy versus chemotherapy alone. Both regimens including targeted therapy were comparable and superior to chemotherapy alone. However, these are preliminary data and further research is required to clarify the role of targeted therapies in the management of advanced NSCLC.
CitationThe place of targeted therapy in the patient management of non-small cell lung cancer. 2007, 57 Suppl 2:S18-23 Lung Cancer
- Phase II study of efficacy and safety of bevacizumab in combination with chemotherapy or erlotinib compared with chemotherapy alone for treatment of recurrent or refractory non small-cell lung cancer.
- Authors: Herbst RS, O'Neill VJ, Fehrenbacher L, Belani CP, Bonomi PD, Hart L, Melnyk O, Ramies D, Lin M, Sandler A
- Issue date: 2007 Oct 20
- Combining targeted agents: blocking the epidermal growth factor and vascular endothelial growth factor pathways.
- Authors: Sandler A, Herbst R
- Issue date: 2006 Jul 15
- Treatment of advanced non-small-cell lung cancer in the elderly.
- Authors: Gridelli C, Maione P, Rossi A, Ferrara ML, Castaldo V, Palazzolo G, Mazzeo N
- Issue date: 2009 Dec
- Investigating the potential of bevacizumab in other indications: metastatic renal cell, non-small cell lung, pancreatic and breast cancer.
- Authors: de Gramont A, Van Cutsem E
- Issue date: 2005
- Angiogenesis inhibition in the treatment of lung cancer.
- Authors: Vokes E, Herbst R, Sandler A
- Issue date: 2006 Nov