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2 Chemos Better Than 1


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The University of Texas MD Anderson Cancer Center


August 2003

http://www.cancerwise.org/August_2003/d ... &color=red

Two is Better Than One Against Lung Cancer

Using Targeted Therapies Together Shows Promise

Interim results of the first clinical trial to combine two experimental targeted therapies to treat advanced non-small cell lung cancer found the regimen to be both safe and more beneficial than expected.

According to researchers at M. D. Anderson, results with a combination of bevacizumab (Avastin™) and erlotinib (Tarceva™) show:

* A 21% response rate in 23 patients treated to date with recurrent stage IIIb or stage IV lung cancer

* Five patients had a partial response in which their lung tumors shrunk by more than 50%, and in one of those patients, tumor size was reduced and has stabilized for almost a year

* A significant number of patients have had minor responses (shrinking of tumors by less than 50%) as well as stabilization of their disease

Study leader Roy S. Herbst, M.D, Ph.D., chief of thoracic medical oncology at M. D. Anderson, collaborated with researchers from the Vanderbilt-Ingram Cancer Center, as well as with other investigators in Great Britain and Europe.

"This is a small pilot trial that tests the concept that two agents targeted against different critical cell pathways may be more effective than just one," he says. "This combination clearly appears to be active, showing encouraging anti-tumor activity.”

The findings are important, Herbst says, because lung cancer takes many forms. And though new therapies that target specific disease processes are promising, physicians will need to target many of those pathways simultaneously to benefit the most patients.

Fewer Side Effects

He added that even at the highest of several doses tested, the treatments were well tolerated with toxicity that was at most mild to moderate in severity.

"We worried about bleeding, but so far I am pleasantly surprised by how well tolerated this combination can be," Herbst says. "However, this treatment must and can only be given under the scrutiny of the clinical trials setting." Results of the trial were presented recently at the annual meeting of the American Society of Clinical Oncology.

Bevacizumab is a monoclonal antibody that works on the outside of a cancer cell to inhibit vascular endothelial growth factor (VEGF), a protein that plays a critical role in tumor angiogenesis (blood vessel formation which usually accompanies the growth of malignant tissue.) The small molecule erlotinib is a tablet designed to work inside the cell to block the signaling pathway of the human epidermal growth factor receptor (HER1) pathway, also known as EGFR, which is involved in cancer cell growth.

"This is just the tip of the iceberg,” Herbst says. “With the recent wave of new molecular therapies approved for cancer we will soon have the ability to rationally identify at-risk patients and combine these agents in our armentarium for maximal effect. There is still much work to be done, but trials like this are critical to the further success against this deadly disease.”

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