In the first phase III study to include Western lung cancer patients, first-line treatment with erlotinib (Tarceva) nearly doubled progression-free survival compared with chemotherapy, according to research presented at the 14th World Conference on Lung Cancer in Amsterdam, hosted by the International Association for the Study of Lung Cancer (IASLC).
Erlotinib is a tyrosine kinase inhibitor (TKI) that targets the epidermal growth factor receptor (EGFR). Non-small cell lung cancer (NSCLC) patients with EGFR activating mutations tend to respond well to TKI therapy.
"Although a growing body of evidence has been emerging about this type of lung cancer, almost all of the studies have been conducted in Asian patients, a group that historically has had significantly different results to NSCLC therapy compared to Western populations," said principal investigator Dr. Radj Gervais, M.D., of the Centre François Baclesse in Caen, France. "EURTAC is the first Phase III study with first-line erlotinib in Western patients with this genetically distinct type of advanced NSCLC."
Researchers tested more than 1,000 patients over a five-year-period to find the study population of 174 patients, which were randomly assigned to receive erlotinib or platinum-based chemotherapy.
The response rate to erlotinib was 54.5%, compared with 10.5% to chemotherapy, according to preliminary results. Progression-free survival in the erlotinib arm was 9.4 months, compared with 5.2 months in the chemotherapy arm. Median survival was 22.9 months in the erlotinib arm and 18.8 months in the chemotherapy arm.
"Our results showed that first-line erlotinib nearly doubled progression-free survival; that's a significant improvement over chemotherapy, with a better tolerability profile," Dr. Gervais said. "We now have results for the use of first-line erlotinib in Asian and Western EGFR mutation-positive patients with NSCLC, and so we can carry this knowledge into our daily practice. I think EURTAC really is a big step towards individualized lung cancer care."