According to results presented at the 42nd annual meeting of the American Society of Clinical Oncology (ASCO), the treatment combination consisting of the targeted agents Avastin (bevacizumab) and Tarceva (erlotinib) may provide an effective and better tolerated treatment option compared to chemotherapy for non-small cell lung cancer (NSCLC) patients who have received prior therapies.

Tarceva has been approved by the FDA for the treatment of patients with recurrent NSCLC and Avastin is approved for the treatment of advanced colorectal cancer. Tarceva is an epidermal growth factor receptor tyrosine kinase inhibitor, and Avastin targets the vascular endothelial growth factor pathway. Researchers have speculated that the combination of agents targeting these two pathways may provide improved results in NSCLC. A previous multicenter trial has shown promising activity for combined Avastin and Tarceva for treatment of recurrent NSCLC (See related news).

The current trial included 120 patients. One group was treated with standard chemotherapy consisting of Taxotere® (docetaxel) plus Alimta® (pemetrexed), a second group was treated with Taxotere/Alimta/Avastin, and the third group was treated with Avastin plus Tarceva.

• There was a trend toward improved progression-free survival in the groups treated with Avastin: 4.8 months for patients treated with chemotherapy/Avastin; 4.4 months for patients treated with Avastin/Tarceva; and 3.0 months for patients treated with chemotherapy only.
• At 6 months, the progression-free survival rate was 30.5% for those treated with chemotherapy/Avastin; 33.6% for those treated with Avastin/Tarceva, and 21.5% for those treated with chemotherapy only.
• At 6 months, patients treated with Avastin/Tarceva had the greatest rate of overall survival (78.3%), compared with 72.1% for those treated with chemotherapy/Avastin, and 60.3% for those treated with chemotherapy only.
• Patients treated with Avastin/Tarceva had greater rates of rash and diarrhea than those treated with the other treatment combinations, however, patients treated with Avastin/Tarceva had lower rates of low levels of immune cells.

These researchers concluded that the targeted treatment combination consisting of Avastin and Tarceva may provide an effective alternative to chemotherapy in the treatment of relapsed NSCLC. Further study is necessary to determine which patients achieve the greatest benefit from each treatment combination.

Comments: This is the first trial to possibly show superiority of targeted therapy over chemotherapy for NSCLC.

Related News

AvastinTM Improves Survival in Advanced Non-Small Cell Lung Cancer (5/15/2005)

Avastin™ Plus Tarceva™ Provides Promising Activity in Recurrent Non-Small Cell Lung Cancer (5/4/2005)

The NCI Announces That Avastin™ with Chemotherapy Prolongs Survival in Non-Squamous NSCLC (3/15/2005)

Avastin™ Plus Tarceva™ Provides Promising Activity in Recurrent Non-Small Cell Lung Cancer (5/4/2005)

Tarceva® Improves Quality of Life in Refractory NSCLC (6/16/2005)

Reference: Fehrenbacher L, O’Neill V, Belani CP, et al. A phase II, multicenter, randomized clinical trial to evaluate the efficacy and safety of bevacizumab in combination with either chemotherapy (docetaxel or pemetrexed) or erlotinib hydrochloride compared with chemotherapy alone for treatment of recurrent or refractory non-small-cell lung cancer. Proceedings of the 42nd annual meeting of the American Society of Clinical Oncology. Atlanta, Ga. June 2-6, 2006. Abstract # 7062.