Painless skin rash predicts survival benefit from latest lung cancer drug, study finds
(Medical Xpress)—Elderly patients with advanced non small cell lung cancer (NSCLC) who developed a rash within 28 days of receiving the targeted drug erlotinib (Tarceva) survived on average 6.2 months, compared to 4.1 months for patients who were given a placebo, results from a major phase III Cancer Research UK-funded trial show today.
And for patients who, in addition to developing the painless rash, also carried mutations in the epidermal growth factor receptors (EGFR) on the surface of their cancer cells, the survival time was even greater at 10.4 months.
Around eight in 10 cases of this form of lung cancer occur in people aged 60 and over, and the average age of patients in the UK is 72 years. Many of these elderly patients are diagnosed at a late stage and already have other illnesses, meaning they are often too frail to be treated with conventional chemotherapy. This means that palliative care is usually the only option available to them.
These trial results show that giving erlotinib to these patients can significantly improve survival, if they develop a rash due to the drug. The findings are published in the journal Lancet Oncology today.
Chief investigator Professor Siow Ming Lee, clinical researcher for Cancer Research UK at the UCL Cancer Institute and consultant at the UCL Hospital Trust, said: "The vast majority of NSCLC patients are elderly and diagnosed at a late stage, often leaving them too frail to cope with the rigours of chemotherapy. Until now, the only option for these patients has been palliative care. But these trial results offer potential hope, with six in every 10 patients who received erlotinib developing a rash that signalled whether or not they were benefitting from this drug treatment. This is extremely encouraging and represents a significant step forward for this group of patients, who often only have a short time left to live.
"Interestingly, we found that women who developed a rash after taking erlotinib tended to survive longer than men. And smokers were less likely to develop a rash than non-smokers or former-smokers, when treated with erlotinib. Further studies to understand the link between skin rash and erlotinib response are urgently needed to find ways of exploiting this relationship for maximum benefit."
Six-hundred and seventy patients took part in the study from 78 hospitals around the UK, conducted by Cancer Research UK and the UCL Cancer Trials Centre. They were randomly assigned to receive tablets containing either erlotinib or a placebo. All patients had advanced stage NSCLC, the majority were aged over 75 and almost all had two or more other medical conditions and were not suitable for chemotherapy treatment.
Liz Woolf, head of Cancer Research UK's patient information website, CancerHelp UK, said: "Lung cancer kills more people in the UK than any other type of cancer - around 96 people every day - with smoking being the biggest preventable cause of this disease. And with the majority of cases diagnosed in older patients with advanced disease, we urgently need treatments that are suitable for these often very ill patients. But equally, we need ways of determining which patients are not likely to benefit, so that they can be spared the side effects that unavoidably accompany such powerful drugs.
"We hope these important trial results will in future mean that more people can benefit from the valuable extra months of life that erlotinib can bring some patients, who would otherwise have very few treatment options.
"Cancer Research UK is in a unique position to help develop new potential treatments like this, while also trying to reduce the tobacco toll by discouraging our children from taking up smoking in the first place. Our campaign for the introduction of plain packaging for cigarettes is essential if we are to beat cancer by targeting it at its source."
More information: Siow Ming Lee et al., First-line erlotinib in patients with advanced non-small-cell lung cancer unsuitable for chemotherapy (TOPICAL): a double blind, placebo-controlled, phase 3 trial, Lancet Oncology (2012), DOI: 10.1016/S1470-2045(12)70412-6
Journal reference: Lancet Oncology
Provided by Cancer Research UK
- EURTAC Phase III study: Erlotinib nearly doubles progression-free survival vs. chemotherapy Jul 05, 2011 | not rated yet | 0
- Advanced lung cancer patients see improved, progression-free survival Nov 13, 2008 | not rated yet | 0
- Scientists looking for second-line defense for patients with NSCLC Jul 25, 2012 | not rated yet | 0
- Erlotinib maintenance therapy prolongs survival in patients with the most common form of lung cancer May 19, 2010 | not rated yet | 0
- Study says VeriStrat predicts response but not survival benefit from erlotinib Oct 15, 2012 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
If you became brain-dead, would you want them to pull the plug?
15 hours ago I'd want the rest of me to stay alive. Sure it's a lousy way to live but it beats being all-the-way dead. Maybe if I make it 20 years they'll...
MRI bill question
May 15, 2013 Dear PFers, The hospital gave us a $12k bill for one MRI (head with contrast). The people I talked to at the hospital tell me that they do not...
Ratio of Hydrogen of Oxygen in Dessicated Animal Protein
May 13, 2013 As an experiment, for the past few months I've been consuming at least one portion of Jell-O or unflavored Knox gelatin per day. I'm 64, in very...
Alcohol and acetaminophen
May 13, 2013 Edit: sorry for the typo in the title , can't edit I looked around on google quite a bit and it's very hard to find precise information on the...
Marie Curie's leukemia
May 13, 2013 Does anyone know what might be the cause of Marie Curie's cancer
Genetic variations within and between populations
May 12, 2013 This paper (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1893020/) asserts these two different conclusions: ---Quote--- Thus the answer to the...
- More from Physics Forums - Medical Sciences
More news stories
(HealthDay)—Concurrent use of two immune checkpoint antibodies—ipilimumab and nivolumab—may be effective for the treatment of advanced melanoma, according to a proof-of-principal study presented in ...
Cancer 11 hours ago | not rated yet | 0
(HealthDay)—The risks of metastasis and death associated with cutaneous squamous cell carcinoma (CSCC) are low, but significant, and risk factors for poor outcome include tumor diameter, invasion beyond ...
Cancer 11 hours ago | not rated yet | 0 |
A new review finds cancer survivors suffer a diverse and complex set of impairments, affecting virtually every organ system. Writing in CA: A Cancer Journal for Clinicians, Julie Silver, M.D., associate professor at Harvar ...
Cancer 16 hours ago | not rated yet | 0
(AP)—A California doctor has been sentenced to 14 years in federal prison for bilking her patients out of more than $1 million by promising that an herbal supplement could cure late-stage cancer and other diseases.
Cancer 16 hours ago | not rated yet | 0
A new oral targeted drug, idelalisib (GS-1101), has the potential to stave off the need for additional treatments for relapsed or treatment-resistant chronic lymphocytic leukemia (CLL), according to a study led in part by ...
Cancer 18 hours ago | not rated yet | 0 |
Big names in medicine are set to give an upbeat assessment of the war on AIDS on Tuesday, 30 years after French researchers identified the virus that causes the disease.
26 minutes ago | not rated yet | 0
For combat veterans suffering from post-traumatic stress disorder, 'fear circuitry' in the brain never rests
Chronic trauma can inflict lasting damage to brain regions associated with fear and anxiety. Previous imaging studies of people with post-traumatic stress disorder, or PTSD, have shown that these brain regions can over-or ...
1 hour ago | not rated yet | 0 |
The neural machinery underlying our olfactory sense continues to be an enigma for neuroscience. A recent review in Neuron seeks to expand traditional ideas about how neurons in the olfactory bulb might encode information about ...
12 hours ago | not rated yet | 0 |
(Medical Xpress)—What if the quality of your work depends more on your focus on the piano keys or canvas or laptop than your musical or painting or computing skills? If target users can be convinced, they ...
13 hours ago | 3.7 / 5 (3) | 0 |
(AP)—A woman who lost both hands, her left leg and right foot after contracting a flesh-eating disease has been fitted with prosthetic hands.
1 hour ago | not rated yet | 0
In 2008 researchers from the University of Southern Denmark showed that the drug thioridazine, which has previously been used to treat schizophrenia, is also a powerful weapon against antibiotic-resistant bacteria such as ...
10 hours ago | 3.7 / 5 (3) | 0 |