Adding cetuximab to chemotherapy reduces advanced lung cancer death risk by 13 percent
While a study last year found that patients lived five weeks, when the target drug cetuximab was added to a particular combination chemotherapy, it is unclear whether the issues that the drug combination chemotherapy is added, also how it affects the progression of the disease and what the magnitude of survival benefit is.
The researchers combined data from four trials investigating the addition of cetuximab to platinum based on different combinations of chemotherapy in first line treatment of non-small cell lung cancer. The results of the meta-analysis, which included a total of 2,018 patients, were presented today in Berlin (Tuesday, 22 September) in the congress of Europe’s largest cancer, ECCO 15 – ESMO 34.
The meta-analysis, integrating the results of several studies, are important to corroborate the results of key studies and give a more accurate estimate of the actual effects of a drug.
“We found that patients who received cetuximab had a 13% lower chance of dying within three years of follow-up compared with those receiving chemotherapy alone,” said Professor Jean-Louis Pujol, president of thoracic oncology at Montpelier Hospital Scholar and professor of medicine at the University of Montpellier in France. “For lung cancer, given that this disease is very resistant to treatment and the prognosis is very poor, with an improvement of this magnitude is significant. This is the same as what you get from chemotherapy after surgery and is accepted as standard treatment. ”
The median survival, a more crude measure of drug effect on death was 9.4 months in the chemotherapy alone group and 10.3 months in the chemotherapy plus cetuximab group.
The meta-analysis also revealed a 10% improvement in progression-free survival, which measures the length of time a patient survives the cancer before it worsens. None of the individual studies were powerful enough to identify any effect on this result on their own because it is difficult to see this in lung cancer because the disease progresses so quickly.
The study also found that patients receiving the addition of cetuximab was 48% more likely to have reduced the tumor volume.
“Less than 30% of patients with advanced lung cancer cells respond to chemotherapy, so despite the addition of cetuximab increases the likelihood of another 48%, bringing the response rate up to 45%, this shows that lung cancer small cell remains a disease that is highly resistant to treatment, “said Professor Pujol.
The benefits to all these results were seen in all subtypes of the disease.
Lung cancer is particularly difficult to treat and is the leading cause of cancer death worldwide, killing an estimated 1.31 million people per year. Patients with advanced disease have few treatment options and about 70% of them die within a year of diagnosis. Less than two percent survive five years. Platinum-based chemotherapy is the standard treatment.
Non-small cell lung cancer is the most common form of lung cancer and most patients have tumors that over-express the receptor of epidermal growth factor receptor (EGFR). Cetuximab belongs to a new class of cancer drugs known as monoclonal antibodies and works by blocking the EGF receptor to stop uncontrolled cell division.
Studies of other EGFR blockers have shown no benefit when combined with chemotherapy in first line treatment of non-small cell lung cancer, although it has been shown to help in the treatment of second line. One explanation for cetuximab benefit demonstrated in this case, while the other drugs targeting the receptor could not be, because it blocks the receptor in a different place. The drug is currently used to treat metastatic colorectal cancer and head and neck cancer. Common side effects include acne-like rash.
“We now have enough evidence to recommend cetuximab in patients with non-small cell lung cancer and we have the confirmation that no matter what type of chemotherapy used to”, said Professor Pujol. “What we now need to investigate is whether this medicine may also help in the early stages of the disease.”
Source: ECCO-the European Organization CanCer
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