A combination of the drugs carboplatin (Paraplatin), paclitaxel (Taxol/Abraxane), cetuximab (Erbitux), and bevacizumab (Avastin) has demonstrated effectiveness against non-small cell lung cancer (NSCLC) in a phase II clinical trial. One hundred two patients with advanced non-squamous NSCLC received the four-drug combo as a first-line treatment. Tumors shrank in 56% of patients and stopped growing in an additional 21%. Patients went an average of 7 months without their cancer progressing; the average survival time was 15 months. Four treatment-related deaths occurred, including two due to hemorrhage (heavy bleeding), which can be a rare but serious effect of Avastin treatment. This side effect profile was within the predefined safety margin. A phase III trial further investigating this drug combination for NSCLC is currently enrolling participants.
Combining cetuximab (Erbitux), bevacizumab (Avastin), and traditional chemotherapy in patients with non-small cell lung cancer (NSCLC) appeared to be safe and effective in a phase II clinical trial. Patients with advanced non-squamous NSCLC received Erbitux and Avastin in addition to carboplatin (Paraplatin) and paclitaxel (Taxol/Abraxane) as first-line treatment, followed by maintenance treatment with Erbitux and Avastin. Tumors shrank in 56% of patients and stopped growing in an additional 21%. Serious side effects were relatively rare; the rate was comparable to that of either Erbitux or Avastin alone. Both Erbitux and Avastin have shown efficacy in NSCLC by themselves, but may be more effective when given together. An ongoing phase III clinical trial will further investigate this drug combination.
Cetuximab and bevacizumab have each been demonstrated to prolong survival when added to chemotherapy in patients with advanced non-small-cell lung cancer (NSCLC). However, the potential benefit of combining cetuximab and bevacizumab together with a platinum-based doublet had not been explored. We designed this phase II trial to evaluate the safety, tolerability, and efficacy of the combination of carboplatin, paclitaxel, cetuximab, and bevacizumab in chemotherapy-naive patients with advanced, nonsquamous NSCLC.
This regimen was safe, feasible, and effective as a frontline treatment of advanced NSCLC, providing the basis for the ongoing phase III trial S0819.
The makers of lorvotuzumab mertansine (IMGN901) have halted a clinical trial investigating the use of the drug in extensive-stage small-cell lung cancer (SCLC). An independent monitoring group recommended ending the trial because patients treated with IMGN901 in addition to the chemotherapy agents etoposide (Etopophos) and carboplatin (Paraplatin) fared no better than patients treated with Etopophos and Paraplatin only. Furthermore, the patient group receiving IMGN901 appeared to have higher rates of infections and infection-related deaths, with at least one death potentially related to IMGN901.
The recent PointBreak clinical trial compared two treatment regimens for non-squamous non-small cell lung cancer (NSCLC). Previously untreated patients with advanced non-squamous NSCLC received initial treatment with carboplatin (Paraplatin), bevacizumab (Avastin), and either pemetrexed (Alimta) or paclitaxel (Taxol/Abraxane). The Alimta-treated group was then given maintenance treatment with Alimta and Avastin, while the other patients received Avastin only. Alimta treatment was associated with slightly longer times until the cancer progressed again (average 6.0 months, compared to 5.6 in the Alimta-free regimen). However, overall survival did not differ between the groups. The two regimens differed in what specific side effect were most common, but had similar overall toxicities and were generally tolerable.
PointBreak (A Study of Pemetrexed, Carboplatin and Bevacizumab in Patients With Nonsquamous Non-Small Cell Lung Cancer) compared the efficacy and safety of pemetrexed (Pem) plus carboplatin (C) plus bevacizumab (Bev) followed by pemetrexed plus bevacizumab (PemCBev) with paclitaxel (Pac) plus carboplatin (C) plus bevacizumab (Bev) followed by bevacizumab (PacCBev) in patients with advanced nonsquamous non–small-cell lung cancer (NSCLC).
Overall survival did not improve with the PemCBev regimen compared with the PacCBev regimen, although progression-free survival was significantly improved with PemCBev. Toxicity profiles differed; both regimens demonstrated tolerability.
Interim results from a phase II clinical trial of the new cancer drug Reolysin in squamous cell carcinoma (SCC) of the lung, a type of non-small cell lung cancer (NSCLC), show that tumors shrank in 23 of 25 patients. The patients had SCC that had spread from its original site, or recurred after treatment, and were treated with the chemotherapy drugs Paraplatin (carboplatin) and Taxol/Abraxane (paclitaxel) in addition to Reolysin. Ten patients experienced tumor shrinkage and 13 experienced stable disease, while the cancer progressed in 2 patients. On average, tumors shrank by a third of their original size. Reolysin consists of a modified form of a virus that selectively attacks cancer cells, while producing no symptoms in most healthy people.
The Spruce trial, a phase II clinical trial examining the effectiveness of the cancer drug OGX-427 in non-small cell lung cancer (NSCLC), is now open for enrollment. The trial will study patients with previously untreated, advanced non-squamous NSCLC. They will receive the chemotherapy agents carboplatin (Paraplatin) and pemetrexed (Alimta) in combination with either OGX-427 or a placebo. The sponsors also plan to add the Cedar trial, which will investigate the use of OGX-427 in squamous cell NSCLC. OGX-427 inhibits Hsp27, a protein that is highly expressed in many tumor cells. The drug may be especially promising for patients without mutations that make them eligible for currently available targeted therapies.
Results from the FASTACT clinical trial suggest that interspersing erlotinib (Tarceva) among rounds of chemotherapy improves outcomes in non-small cell lung cancer (NSCLC). Patients with advanced NSCLC received six cycles of gemcitabine (Gemzar) plus carboplatin (Paraplatin) or cisplatin (Platinol), with Tarceva added during the second half of each chemotherapy cycle. This regimen prolonged time without cancer worsening and increased survival compared to patients who had received chemotherapy and placebo, though the benefit was only seen in patients with mutations in the EGFR gene. This approach may be most useful for patients whose EGFR status is unknown, as patients with known EGFR mutations may be even better served by first-line treatment with Tarceva alone.