According to a recent article published in the Journal of Clinical Oncology, efaproxiral (RSR13) may improve outcomes in patients with non-small cell lung cancer who are undergoing chemotherapy and radiation therapy.

Lung cancer remains the leading cause of cancer-related deaths in the United States. Non-small cell lung cancer (NSCLC), the most common form of lung cancer, refers to the type of cell within the lung where the cancer originated. Standard treatment for NSCLC largely depends upon the stage, or extent of spread of cancer; options may include surgery, chemotherapy, radiation therapy, and/or targeted therapy. Locally advanced NSCLC refers to cancer that has spread from the lung, but not outside the chest. Unfortunately, once the cancer has spread from its site of origin, cure rates remain dismal following standard therapy. Therefore, research efforts are focused on improving the duration of survival as well as improving quality of life for patients with this disease.

Efaproxiral is still being evaluated in clinical trials. This agent is intended for use in addition to radiation therapy, with the goal of improving anti-cancer responses over radiation therapy alone. It works by increasing oxygen levels in cancer cells, which augments the ability of radiation therapy to kill the cells.

A multi-institution clinical trial was recently conducted to further evaluate the effectiveness of efaproxiral when added to radiation therapy in the treatment of NSCLC. This trial included 51 patients with locally advanced NSCLC who were initially treated with the standard chemotherapy combination consisting of Taxol® (paclitaxel) and Paraplatin® (carboplatin), followed by radiation therapy plus efaproxiral. Results from this trial were compared to results from a previous large trial (referred to as RTOG 94-10) in which the same chemotherapy combination was used with radiation therapy in the treatment of locally advanced NSCLC.

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Seventy-five percent of trial participants achieved an anti-cancer response following treatment including efaproxiral. The average duration of survival was approximately 21 months. Overall survival rates at 1-2 years following therapy were 67% and 37%, respectively. In comparison, the average duration of survival in the earlier RTOG 94-10 trial was less than 18 months. Treatment with efaproxiral was well tolerated; severe side effects were relatively rare and consisted of low levels of oxygen in the blood, fatigue, and damage to tissues in the lung associated with radiation therapy.

The researchers concluded that the addition of efaproxiral to standard chemotherapy and radiation therapy appears promising in the treatment of locally advanced NSCLC. Future clinical trials are necessary to directly compare treatment with or without efaproxiral to truly determine its effectiveness. Patients with locally advanced NSCLC who are to undergo treatment including radiation therapy may wish to speak with their physicians regarding their individual risks and benefits of participation in a clinical trial further evaluating efaproxiral or other promising therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.

Reference: Choy H, Nabid A, Stea B, et al. Phase II Multicenter Study of Induction Chemotherapy Followed by Concurrent Efaproxiral (RSR13) and Thoracic Radiotherapy for Patients With Locally Advanced Non–Small-Cell Lung Cancer. Journal of Clinical Oncology. 2005; 23: 5918-5928.

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