Switching from Iressa to Tarceva Halts Drug-Induced Immune Suppression in Lung Cancer Patient

Neutropenia (a reduction in white blood cells) is a rare, but potentially serious side effect of the cancer drug gefitinib (Iressa). Iressa is used to treat non-small cell lung cancer (NSCLC) with mutations in the EGFR gene. A patient with EGFR-mutant advanced adenocarcinoma of the lung (a type of NSCLC) was treated with Iressa. Her tumor shrank, but she experienced severe neutropenia, leaving her at risk of dangerous infections. She was switched to erlotinib (Tarceva), another EGFR inhibitor, after which her neutropenia cleared up. The patient has since continued on Tarceva without neutropenia or cancer progression for over 9 months. This case suggests that Iressa-induced neutropenia can be safely treated by switching to Tarceva, although caution should be used in drawing conclusions from a single case study.

From GRACE: Molecular Markers: The More You Seek, the More You Find

This week, we borrow a post from the excellent website of the Global Resource for Advancing Cancer Education (GRACE). GRACE founder and president Dr. Jack West is an oncologist who treats people with lung cancer. In the video below, he discusses his evolving views on molecular testing. To see the original post, and to explore the many other resources offered by GRACE, click here.

Continue reading…

Dachshund Binds p53 To Block The Growth of Lung Adenocarcinoma Cells

Given the importance of EGFR signaling in lung cancer etiology, we examined the role of Drosophila gene Dachshund DACH1 expression in lung cancer development. We conclude that DACH1 binds p53 to inhibit NSCLC cellular growth.

Tarceva Improves Quality of Life in Certain Lung Cancer Patients

Updated results from a clinical trial showed that patients who were treated with the drug erlotinib (Tarceva) had better quality of life than those receiving standard chemotherapy. The OPTIMAL study is a phase III clinical trial investigating erlotinib (Tarceva) as a first-line treatment for people with advanced non-small cell lung cancer (NSCLC) who have a mutation in the EGFR gene. Tarceva-treated patients scored higher on questionnaires assessing physical, social/family, emotional, and functional well-being. The updated results also confirmed that Tarceva-treated patients experienced longer periods without worsening of their cancer compared to chemotherapy-treated patients.

Quality of life analyses from OPTIMAL (CTONG-0802), a phase III study of first-line erlotinib versus chemotherapy in patients with advanced EGFR mutation-positive NSCLC

The OPTIMAL study found that erlotinib improved progression-free survival (PFS) versus standard chemotherapy in Chinese patients with advanced EGFR mutation-positive non-small-cell lung cancer (NSCLC). This report describes the quality of life (QoL) and updated PFS analyses from this study.

Erlotinib improves QoL compared with standard chemotherapy in the first-line treatment of patients with EGFR mutation-positive advanced NSCLC.

CNS metastases in non-small-cell lung cancer: Current role of EGFR-TKI therapy and future perspectives

In NSCLC patients with activating epidermal growth factor receptor gene (EGFR) mutations EGFR-specific tyrosine kinase inhibitors (TKI) represent effective and well tolerated modes of therapy, however, it has been unclear whether these drugs are also able to cross the blood–brain-barrier (BBB) and cause remission of CNS metastases. Recent studies suggest that this might indeed be the case and intracerebral response rates of 70–80% in molecularly selected patients are considerably higher compared to what would be expected for standard approaches like systemic chemotherapy and whole brain radiation therapy.

Uncommon Epidermal Growth Factor Receptor mutations in non-small cell lung cancer and their mechanisms of EGFR tyrosine kinase inhibitors sensitivity and resistance

We summarize the literature and present an overview of the subject of less common EGFR mutations and their clinical significance, with an emphasis on EGFR TKI sensitivity or resistance.

Polytherapy Beats Monotherapy as Second-Line Treatment for NSCLC

Combining targeted therapy improves overall survival for patients with non-small cell lung cancer (NSCLC), compared to using the targeted drug erlotinib (Tarceva) alone, according to a recent study. By pooling data from eight clinical trials, researchers found that patient outcomes were improved when combination therapy was used as a second-line treatment for NSCLC.

Patients with advanced NSCLC who have already received initial therapy usually take erlotinib alone as a second-line treatment. Erlotinib directly targets the EGFR protein and can be particularly effective for patients with mutations in the EGFR gene. Continue reading…

Association of epidermal growth factor receptor and K-Ras mutations with smoking history in non-small cell lung cancer patients

Our aim was to investigate the presence and association of EGFR and K-Ras mutations in 50 primary NSCLC patients with a smoking history by using real-time PCR and sequencing. EGFR mutations were detected in four patients (8%). Two of these mutations were L858R mutations and the remaining two were deletion mutations spanning between codons 746 and 750. The L858R mutation was significantly associated with smoking status (P=0.003). K-Ras codon 12 and 61 mutations were also observed in four patients. However, no association was observed between K-Ras mutations and the tumor staging, gender, histology and smoking status of the patients.