According to results published in a recent online edition of the Journal of Clinical Oncology, the addition of the monoclonal antibody Erbitux® (cetuximab) to chemotherapy appears well tolerated and improves outcomes for patients with advanced non-small cell lung cancer. Future trials are necessary to determine the true benefit of adding Erbitux to standard therapy for this disease.
Lung cancer remains the leading cause of cancer death in the US. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for 75%-80% of all lung cancers. Survival for patients with advanced lung cancer is poor; less than 10% of patients are expected to survive for five years or longer.
Initial treatment of advanced NSCLC often involves a platinum-based chemotherapy regimen. In an attempt to reduce toxic effects of treatment while maintaining or even increasing effectiveness, researchers are evaluating alternative treatment options to use independently or in addition to chemotherapy.
Erbitux is a monoclonal antibody that is currently FDA approved for the treatment of metastatic colorectal cancer; it is approved as a single agent or in combination with the chemotherapy agent Camptosar® (irinotecan). Erbitux has been designed to bind to a specific site on cancer cells that is involved in cellular replication -the epidermal growth factor receptor (EGFR).
Researchers from multiple institutions recently conducted a clinical trial to evaluate the addition of Erbitux to the commonly used chemotherapy combination carboplatin (Paraplatin®) and paclitaxel (Taxol®). This trial included 31 patients with stage IV NSCLC who had not received prior treatment. The following results were observed:
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- Shrinking of the cancer occurred in 26% of patients.
- The median time to cancer progression was 5 months.
- The median survival was 11 months.
- Survival at 1 year was 40%; survival at 2 years was 16%.
- The addition of Erbitux was well tolerated; the most common associated side effect was rash.
The researchers concluded that the addition of Erbitux to carboplatin/paclitaxel appears well tolerated and effective in the treatment of advanced NSCLC. The authors state that the results appear superior to historical data evaluating carboplatin/paclitaxel only in patients with this stage of disease; future clinical trials further evaluating this new treatment regimen are underway. Furthermore, patients with specific EGFR mutations may achieve greater benefit from the addition of Erbitux.
Patients with stage IV NSCLC may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating Erbitux or other novel therapeutic approaches. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.
Reference: Thienelt C, Bunn P, Hanna N, et al. Multicenter Phase I/II Study of Cetuximab With Paclitaxel and Carboplatin in Untreated Patients With Stage IV Non-Small-Cell Lung Cancer. Journal of Clinical Oncology. 2005. Published on-line ahead of print October 24, 2004. DOI: 10.1200/JCO.2005.03.1997.
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