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The combination of Erbitux® (cetuximab), Paraplatin® (carboplatin), and either Taxol® (paclitaxel) or Taxotere® (docetaxel) is well tolerated and clinically active in patients with advanced non–small cell lung cancer (NSCLC), according to the results of two recent studies.[[1]]( "_ednref1"), [[2]]( "_ednref2")

Non–small cell lung cancer (NSCLC) accounts for roughly 85% of all lung cancer. In advanced NSCLC cancer has spread outside the lung; standard therapy for this stage of disease includes chemotherapy. Because of suboptimal survival rates for advanced NSCLC, researchers continue to evaluate novel ways to improve outcomes for patients with this disease.

Treatment for NSCLC often includes different combinations of different types of chemotherapy agents-for example, platinum-based drugs (such as Paraplatin) in combination with taxanes (such as Taxol). More recently, researchers have been evaluating the addition of targeted agents, such as Erbitux, to chemotherapy regimens. Erbitux is a drug that inhibits growth of the cancer by binding to a portion of the epidermal growth factor receptor (EGFR), a protein located on the surface of many cancer cells, including NSCLC.

Researchers from the Fox Chase Cancer Center conducted a Phase II study to evaluate the combination of Erbitux, Paraplatin, and Taxol. The study included 53 patients who received the three-drug combination for up to six cycles and then weekly Erbitux for one year or until disease progression. The response rate was 57%, including three patients with a complete response. At a median follow-up of 12.5 months, the estimated overall survival is 13.8 months and the progression-free survival is 5.5 months. At one year 18.9% of patients were free from progression.

In a similar study conducted at the Penn State Hershey Cancer Center, researchers evaluated the combination of Erbitux, Paraplatin, and Taxotere in 80 patients with advanced or metastatic NSCLC. Patients received up to six cycles of the three-drug combination followed by weekly Erbitux for one year or until disease progression. The objective response rate was 15.2%, with a median progression-free survival of 4.6 months and a median overall survival of 10.3 months.

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There were no severe adverse events in either study. The combined results of both of these studies indicate that Erbitux and Paraplatin plus a taxane is a well-tolerated regimen that produces anticancer activity for patients with advanced and metastatic NSCLC and that the side effects appear to be manageable.


[[1]]( "_edn1") Borghaei H, Langer CT, Millenson M, et al. Phase II study of palcitaxel, carboplatin, and cetuximab as first line treatment for patients with advanced non-small cell lung cancer (NSCLC): Results of OPN-017. Journal of Thoracic Oncology. 2008; 3(11):1286-1292.

[[2]]( "_edn2") Belani CP, Schreeder MT, Steis RG, et al. Cetuximab in combination with carboplatin and docetaxel for patients with metastatic or advanced-stage nonsmall cell lung cancer: A multicenter phase 2 study. Cancer. 2008; 113:2512-2517.

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