A multi-institution US study has determined the addition of Avastin (bevacizumab) to Tarceva (erlotinib) or to chemotherapy improves survival compared with chemotherapy alone in the treatment of recurrent non–small cell lung cancer (NSCLC). The details of this study appeared in an early on-line publication in the Journalof Clinical Oncology on October 1, 2007.

Advancements of novel therapies in the treatment of cancer have included development of more targeted therapies that tend to result in fewer side effects than chemotherapy. Avastin and Tarceva are both agents that are targeted against components that contribute to growth or spread of cancer cells. Avastin is targeted against the vascular endothelial growth factor receptor (VEGF), and Tarceva is targeted against the epidermal growth factor receptor (EGFR). These agents bind to their respective targets and reduce or prevent the uncontrolled growth and spread of cancer cells.

Researchers from several medical institutions in the United States recently conducted a clinical trial to compare different regimens for the treatment of recurrent NSCLC. This trial included 120 patients with NSCLC who had received at least one prior therapy. Patients were treated with either Avastin plus Tarceva, Avastin plus chemotherapy (Taxotere® (docetaxel) or Alimta® (pemetrexed), or chemotherapy only.

• Survival rates at one year were as follows: 57.4% for patients treated with Avastin plus Tarceva; 53.8% for patients treated with Avastin plus chemotherapy; and 33.1% for patients treated with chemotherapy only.
• Only 13% of patients treated with Avastin/Tarceva discontinued treatment due to side effects compared with 24% for patients treated with chemotherapy only and 28% for patients treated with Avastin plus chemotherapy.
• There were no unexpected side effects with any treatment regimen.
• Progression-free survival (PFS) was also improved in the treatment groups including Avastin compared with the chemotherapy-only group.

The researchers concluded that, for patients with NSCLC who have received prior therapy, “Results for PFS and overall survival favor combination of bevacizumab with either chemotherapy or erlotinib over chemotherapy alone.”

Comments: These data further document the effectiveness of targeted therapy in the palliative treatment of patients with advanced NSCLC.

Reference: Herbst R, O’neill V, Fehrenbacker L, et al. Phase II study of efficacy and safety of bevacizumab in combination with chemotherapy or erlotinib compared with chemotherapy alone for treatment of recurrent or refractory non-small-cell lung cancer. Journal of Clinical Oncology [early online publication]. October 1, 2007; 12: 3026.  

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