Persons with advanced non-small cell lung cancer often undergo chemotherapy with a combination of drugs to alleviate the symptoms of disease and prolong survival time. Now, researchers who are presenting their findings at the May 2000 American Society of Clinical Oncology conference report that a novel new biologic therapy, a monoclonal antibody called Rhumab VEGF, may enhance the effectiveness of chemotherapy in treating this disease.

Non-small cell lung cancer (NSCLC) is a term used to describe several types of lung cancer, including epidermoid or squamous carcinoma, adenocarcinoma, large cell carcinoma, adenosquamous carcinoma, and undifferentiated carcinoma. Treatment options for NSCLC may include surgery, radiation therapy, chemotherapy, and/or biologic therapy, depending on the stage of the cancer (extent of disease at diagnosis).

Stage IIIB NSCLC is usually inoperable and is characterized by cancer that originated in the lung and then spread to other parts of the chest. Stage IV NSCLC is cancer that originated in the lung and then spread to other parts of the body (called metastatic disease). Several chemotherapy combinations may be used to treat persons with this type of disease, with 1 of the most active being carboplatin and paclitaxel. However, researchers continue to develop and study new agents, including biologic therapies, with the hope of providing more effective treatment options.

A substance in the body, called vascular endothelial growth factor (VEGF), plays a crucial role in the progression of cancer by stimulating the new growth of blood vessels. In essence, VEGF stimulates the body to provide a blood supply for a newly developing cancer. Researchers have developed a type of antibody, a recombinant humanized monoclonal antibody called

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Rhumab VEGF, that inhibits the effects of VEGF in the body. For the first time, this monoclonal antibody has been studied in a large number of persons with advanced NSCLC.

Researchers assigned 99 persons with stage IIIB or stage IV NSCLC to receive either A) chemotherapy with paclitaxel and carboplatin alone or B) chemotherapy with paclitaxel and carboplatin plus Rhumab VEGF. The response rate for those receiving chemotherapy only was 25%, compared with 34% for those receiving Rhumab VEGF as well. The average time it took for the cancer to begin growing again (called time to progression) was 181 days for those undergoing the chemotherapy only, and 207 days for those also receiving the monoclonal antibody.

These findings suggest that adding a monoclonal antibody to a chemotherapy regimen may improve the outcomes for many persons with NSCLC. Clinical studies to evaluate Rhumab VEGF, combined with a variety of other anticancer therapies, in persons with NSCLC are ongoing. Persons who have NSCLC may wish to talk with their doctor about the risks and benefits of participating in a clinical trial in which Rhumab VEGF or other promising new treatments are being studied. Two sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute (cancer.gov) and the Clinical Trials section and service offered by Cancer Consultants.com (www.411cancer.com). (Proceedings of the American Society of Clinical Oncology, Vol 19, pp 485a, Abstract 1896, 2000)

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