According to a recent article published in the Journal of Clinical Oncology, treatment with single-agent Tarceva® (erlotinib) provides anticancer activity in patients with advanced liver cancer.
The liver is the largest organ in the body and is responsible for over 500 functions. These include the secretion of glucose, proteins, vitamins, and fats; the production of bile; the processing of hemoglobin; and detoxification of numerous substances. Primary liver cancer starts in the cells of the liver and can spread through blood or lymph vessels to different parts of the body. Approximately 85% of all liver cancers that start in the liver (primary liver cancer) are classified as hepatocellular carcinoma (HCC).
HCC that cannot be surgically removed-either due to its anatomical location, its extent of spread in the body, or a patient’s inability to tolerate surgery-is referred to as unresectable. HCC that has spread to distant sites in the body is referred to as metastatic. Treatment options for patients with unresectable or metastatic HCC, especially for those who have received prior therapy, is limited. Researchers continue to evaluate novel therapeutic approaches for patients with this disease.
Tarceva is a fairly new agent that is currently approved for the treatment of advanced non-small cell lung cancer (NSCLC) that has stopped responding to prior therapies. It works by blocking a biological pathway referred to as the epidermal growth factor receptor (EGFR) pathway. The EGFR pathway is involved in cell growth and replication, and when mutated or altered, excessive replication of cells can occur. Tarceva blocks mutated EGFR and thus reduces the uncontrolled replication and growth of cancer cells. It is currently being evaluated in various cancers in clinical trials.
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A multi-institutional clinical trial was recently conducted to evaluate Tarceva in the treatment of advanced HCC. The trial included 38 patients; nearly half of whom had received prior therapy for their disease. Patients had either unresectable or metastatic HCC and were treated with single-agent Tarceva.
Nearly 60% of patients experienced a regression or stabilization of their disease. At 6 months, 32% of patients still had experienced no progression of their cancer. Overall, these patients survived for an average of more than one year (13 months). Treatment was generally well tolerated; few patients experienced severe side effects.
The researchers concluded that treatment with single-agent Tarceva provides anti-cancer responses and may provide improved long-term outcomes in some patients with unresectable or metastatic HCC. The authors state that future clinical trials are warranted to further evaluate Tarceva in HCC. Patients with unresectable or metastatic HCC may wish to speak with their physician regarding their individual risks and benefits of participation in a clinical trial further evaluating Tarceva or other novel therapeutic approaches. Sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov).
Reference: Philip P, Mahoney M, Allmer C, et al. Phase II Study of Erlotinib (OSI-774) in Patients With Advanced Hepatocellular Cancer. Journal of Clinical Oncology. 2005; 23: 6657-6663.