In a nutshell
This study compared the efficacy of erlotinib (Tarceva) versus GemCarbo chemotherapy in patients with advanced epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC). The study also compared the effect of the two treatments on the quality of life (QoL) of the patients.
Some background
EGFR is a protein normally found on the surface of cells that plays a role in the growth and multiplication of cells. EGFR is part of the tyrosine kinase family (a class of cell surface proteins). A mutated (defected) EGFR causes cells to grow and spread uncontrollably, thus promoting cancer formation. Patients with EGFR-mutation-positive NSCLC respond to treatment with a class of drugs known as tyrosine kinase inhibitors (TKIs), such as erlotinib.. Erlotinib is a type TKI that blocks the stimulating action of EGFR on cellular division and growth. Erlotinib is an initial treatment for patients with NSCLC whose cancer has spread to other parts of the body and that has certain types of EGFR mutations.
GemCarbo is the name of a chemotherapy combination of gemcitabine (Gemzar) and carboplatin (Paraplatin). GemCarbo is the first treatment option for patients with advanced) spread NSCLC. However, chemotherapy has many side effects which reduce the quality of life of patients. Quality of life (QoL) is an assessment of an individual's emotional, functional, and physical wellbeing. QoL is important in the determination of the overall benefit of a treatment. This study aimed to evaluate the efficacy of erlotinib versus GemCarbo chemotherapy and the QoL of patients associated with these treatments.
Methods & findings
This study included 154 patients with advanced NSCLC and confirmed EGFR mutations. Of the 154 patients, 128 were included in the evaluation of the QoL. 74 patients were randomly assigned to treatment with 150 mg of erlotinib daily, while the other 54 were treated with GemCarbo chemotherapy. The main parameters evaluated were progression free survival or PFS (the length of time during and after the treatment patients survive without the cancer progressing) and QoL.
Results showed that treatment with erlotinib significantly improved PFS compared to GemCarbo. Patients treated with erlotinib had an average PFS of 13.7 months while those on GemCarbo had a PFS of 4.6 months. Overall, erlotinib notably improved all aspects that define QoL as compared to those treated with GemCarbo. Additionally, patients treated with erlotinib improved faster their QoL than patients treated with GemCarbo.
The bottom line
This study concluded that erlotinib improved both QoL and PFS when used as a first-line treatment in patients with EGFR mutation-positive NSCLC.
The fine print
This study included a small number of participants. Larger studies are needed to confirm these promising findings.
What’s next?
Talk to your doctor about the most appropriate treatment in your situation.
Published By :
Annals of oncology
Date :
May 30, 2013
