The future of lung cancer? Why, it’s er…lotinib

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When you look at chemotherapy regimes carefully, you’ll realise that there are many agents in use that have been around for decades. Over time, doses and timing have been modified, and slowly, we’ve seen the advent of new agents creeping in together with the old stuff. 

We recently talked about the new agents for melanoma, in relation to BRAF, IL-2, and CTLA-4. The acronym in vogue for non-small cell lung cancer? EGFR. 

EGFR, or epidermal growth factor receptor, is one of the tyrosine kinases, in the same family as HER-2. EGFR lives on the surface of the cell, and when mutated, could lead to uncontrolled cell division – and you know what that means. 

In fact, it’s associated with lung, breast, anal and colorectal cancer as well as glioblastoma multiforme. Gefinitib, a tyrosine kinase inhibitor, was the first generation, and was proven to significantly improve progression free survival in patients who have a mutation of EGFR, compared with carboplatin and paclitaxel.

Then there was the SATURN trial, checking out erlotinib as maintenance therapy, where it found a good footing in improving progression free survival after first line chemotherapy. 

Now, there’s this from the Lancet – erlotinib as first line therapy in those with non small cell lung cancer with a proven EGFR mutation. Compared with the combination of gemcitabine and carboplatin, progression free survival was markedly longer – 13.1 months vs 4.6 months. Being more specific than the standard chemotherapy, the side effects were significantly less as well. 

Funded by Roche, but still an interesting result nonetheless, and signals a new area of chemotherapy for solid organ malignancy. Check out this study here


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