Researchers recently reported that a combination of the epidermal growth factor receptor (EGFR) targeted agents Gilotrif® (afatinib) and Erbitux® (cetuximab) were able to effectively shrink EGFR positive non-small cell lung (NSCLC)cancer that had stopped responding to the EGFR inhibitors Tarceva® (erlotinib) and Iressa® (gefitinib). This novel combination appeared to benefit patients regardless of whether their cancer had acquired second line resistance to either drug.
Lung cancer remains the leading cause of cancer death in the United States and abroad, highlighting the importance of finding more effective approaches to treatment. In the United States, NSCLC accounts for 75–80% of all lung cancers. Although progress has been made in recent years the majority of patients with advanced stage lung cancer still die from their disease. New treatments are sorely needed.
As cancer research has evolved, it has become increasingly clear that the specific characteristics of the cancer can have a profound effect on the behavior of the cancer and its response to specific treatments. In NSCLC, mutations in the EGFR gene may influence whether the cancer responds to the EGFR-targeted drugs Tarceva and Iressa. Among patients with advanced NSCLC that test positive for a mutation in the EGFR gene, initial treatment with the targeted therapy Tarceva produces better outcomes and fewer serious side effects than chemotherapy. These EGFR targeted therapies have become the standard of care in NSCLC patients that are EGFR positive, however resistance to these targeted treatments still occurs over time and new treatment options are needed.
Patients treated in this clinical study were heavily pretreated and had EGFR-mutant lung cancer that was resistant to treatment with Tarceva/Iressa. Of the 126 patients treated with the combination therapy, 29% had a confirmed partial or complete disappearance of their cancer that lasted for an average duration of 5.7 months.
Reference: Janjigian Y, Smit E, Groen H, et al. Dual inhibition of EGFR with Afatinib and Cetuximab in Kinase Inhibitor-Resistant EGFR-Mutant Lung Cancer with and without T790M Mutations. Cancer Discovery. Published online First July 29, 2014.
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