Source: Annual Congress 2009 - Treatment of lung cancer
Disease area: Thoracic oncology

Abstract

Purpose: To evaluate the efficacy of erlotinib, an agent that targets the human epidermal growth factor receptor (EGFR), and bevacizumab, which targets vascular endothelial growth factors (VEGF), compared to classical chemotherapy in patients with advanced NSCLC.
Method: 59 patients with first diagnosed stage IIIb-IV lung adenocarcinoma were randomized. 12/59 pts received docetaxel 100mg/m² plus carboplatin AUC=5.5 (DC) (Group A); 15/59 DC plus erlotinib 150 mg daily (Group B); 20/59 DC plus bevacizumab 7,5 mg/kg (Group C) and 12/59 DC plus erlotinib 150 mg daily plus bevacizumab 7,5 mg/kg (Group D). DC were administered for 6 cycles and targeted therapies were continued until progression. We estimated the levels of VEGF and EGFR at the time of diagnosis in the serum by ELISA. Expression of VEGF and EGFR in biopsy tissue was also evaluated by IHC.
Results: Group B had a statistically significant survival benefit in comparison to groups C and D (p= 0.038). Although median survival of Group B was 3 months longer than Group A, there was no statistically significant difference. Patients receiving erlotinib experienced more frequently rash and diarrhoea but they were well managed. Expression of VEGF in biopsy tissue was statistically significant related to early time to progression in patients who received DC plus bevacizumab (p=0.01). Elevated levels of VEGF in serum were statistically significant related to short survival (p=0.007) in Group A.

Group	Overall survival in months	CI 95%
A	10.7	5-16.4
B	13.7	6.2-21
C	10.2	7.9-12.6
D	9.4	8.5-10.4

Conclusion: DC and erlotinib showed to have a more favourable overall survival rate only in comparison to bevacizumab alone and to their combination.

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E. Boutsikou, P. Zarogoulidis, E. Galaktidou, I. Sapardanis, G. Balassoulis, L. Sakkas, T. Kontakiotis, K. Zarogoulidis (Exohi, Thessaloniki, Thessaloniki, Greece). A preliminary study on targeted therapies in advanced lung cancer patients. Eur Respir J 2009; 34: Suppl. 53, 2650

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