While new treatments for non-small cell lung cancer (NSCLC), such as tyrosine kinase inhibitors (TKIs) and Alimta (pemetrexed), are effective second-line treatments for patients whose tumors carry mutations in the EGFR gene, they are less effective for patients without such mutations. Twenty-six patients with inoperable, previously treated NSCLC received treatment with amrubicin (Calsed) and S-1 and experienced higher treatment response rates, longer periods without cancer progression, and longer overall survival than has been reported with single-agent chemotherapy. The beneficial effects were independent of cancer subtype, suggesting that combined Calsed and S-1 may be an effective second-line treatment for NSCLC without EGFR mutation.
A review of recent research discusses EGFR inhibition in the treatment of lung cancer. Scientists have now demonstrated that EGFR-tyrosine kinase inhibitors (TKIs), either by themselves or combined with chemotherapy, are effective first-line treatments for advanced non-small cell lung cancer (NSCLC) with EGFR mutations, and as second-line or maintenance treatments for all advanced NSCLC. TKIs like erlotinib (Tarceva) or gefitinib (Iressa), or anti-EGFR antibodies like cetuximab (Erbitux), may also enhance the effectiveness of radiation therapy for locally advanced NSCLC. Other biomarkers, such as KRAS mutations, may also help predict response to EGFR inhibition therapy.
Erlotinib (Tarceva) was recently approved in the EU as a first-line treatment for advanced non-small cell lung cancer (NSCLC) in patients with mutations in the EGFR gene. In these patients, this recently published guide explains, Tarceva is better tolerated than standard chemotherapy, has higher treatment response rates, and results in longer time periods without the cancer worsening. However, Tarceva does not benefit patients without EGFR mutations, its effect on overall survival has not yet been clearly determined and the risk of serious side effects requires careful patient monitoring.