According to a recent article published in the Journal of Clinical Oncology, the treatment combination consisting of Erbitux (cetuximab) plus Gemzar (gemcitabine) and Paraplatin (carboplatin) appears to provide promising anticancer activity for the treatment of stage IV non-small cell lung cancer. This combination is also well tolerated.

Lung cancer remains the leading cause of cancer-related deaths in the U.S. and Europe. Non-small cell lung cancer (NSCLC) is the most common type of lung cancer; it is named for the type of cell within the lung where the cancer originated. Stage IV NSCLC refers to cancer that has spread from the lung to distant sites in the body. Treatment for stage IV NSCLC is typically not intended to be curative, but rather to extend the duration of a patient’s life and improve their quality of life.

Standard treatment for stage IV NSCLC is chemotherapy, radiation therapy, and/or biologic therapy. These agents may be used in combination or as single agents. Gemzar and carboplatin are two chemotherapy agents that may be used for the treatment of NSCLC.

Erbitux is a monoclonal antibody (protein) that is designed to bind to a specific component of the epidermal growth factor receptor (EGFR) pathway. The EGFR pathway has been a recent focus of research since it plays a role in cellular replication and is often over expressed in cancer.

Erbitux is designed to inhibit EGFR’s effects on cellular replication. Erbitux is currently FDA-approved in combination with irinotecan for the treatment of colorectal cancer that has stopped responding to irinotecan-based chemotherapy. The drug is also approved as a single agent in patients who are not able to tolerate treatment with irinotecan. Erbitux is currently being evaluated in clinical trials for the treatment of various types of cancer.

Researchers from the University of Alabama and the MD Anderson Cancer Center recently conducted a clinical trial to evaluate the combination of Gemzar/carboplatin plus Erbitux in the treatment of stage IV NSCLC. This trial included 35 patients who had not received prior therapy. All participants were treated with Gemzar/carboplatin and Erbitux. Overall, this treatment combination was well tolerated and, compared to historical data, demonstrated promising anticancer activity.

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  • Nearly all patients experienced benefit from this treatment regimen.
  • Ten patients had a partial shrinkage or disappearance of their cancer.
  • Twenty-one patients achieved disease stabilization.
  • The median time to cancer progression was 165 days.
  • The median overall survival was 310 days.
  • The majority of side effects were mild to moderate. Those associated with Erbitux were rash, dry skin, weakness, dry or sore mouth, fever/chills, and nausea/vomiting.
  • Low levels of blood cells were the most common side effects associated with chemotherapy.

The researchers concluded that the treatment combination consisting of Erbitux/Gemzar/carboplatin appears quite promising as initial treatment of stage IV NSCLC when compared to historical data. Furthermore, most of the side effects associated with Erbitux were not severe. The researchers stated that this treatment regimen warrants further evaluation.

Patients diagnosed with NSCLC may wish to speak with their physician regarding their individual risks and benefits of participating in a clinical trial further evaluating this treatment combination or other novel therapeutic regimens. Two sources of information regarding ongoing clinical trials include the National Cancer Institute (www.cancer.gov) and www.cancerconsultants.com.

Reference: Robert F, Blumenschein G, Herbst R, et al. Phase I/IIa Study of Cetuximab With Gemcitabine Plus Carboplatin in Patients With Chemotherapy-Naïve Advanced Non–Small-Cell Lung Cancer. Journal of Clinical Oncology. 2005; 23: 9089-9096.

Related News: Erbitux® in Addition to Chemotherapy for Advanced Non-Small Cell Lung Cancer (10/31/05)

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