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13th World Conference On Lung Cancer Focuses On Advanced Targeted Therapies Effective As First-Line Treatment

PRS.4) Doctors are constantly on the look out for advancements to better treat and tailor cancer treatment to the individual. Targeted therapies have been introduced that have improved standard chemotherapy approaches. Combining targeted therapies in specific patients with lung cancer may reduce the need for chemotherapy, and increased understanding of the targets involved in the pathogenesis of lung cancer may help to individualize drug therapy. One of these targeted therapies is gefitinib, a tyrosine kinase inhibitor (TKI) that targets the epidermal growth factor receptor (EGFR), a protein that causes cancer cells to divide. Gefitinib has shown high response rate and extended survival in never-smoker lung cancer patients, especially in those with an EGFR mutation. In this randomized phase III trial, researchers sought to compare the efficacy of gefitinib as a first-line treatment with standard chemotherapy in patients who were never-smokers. Investigators randomized 309 never-smokers living with late-stage lung cancer into two groups. One group received gefitinib and the other group received chemotherapy. While the gefitinib did not show an improved overall survival, results showed the group receiving gefitinib had a higher response rate and a significantly better progression-free survival (PFS, length of time during and after treatment when a patient"s disease does not worsen) than those receiving chemo. Also, high-grade toxicity was less common in the gefitinib group than in the chemotherapy group. Additionally, in the gefitinib group, PFS in the mutation-negative subgroup was shorter than that of the mutation-positive group (with a median of 2.1 vs. 8.4 months). There was no difference between these two subgroups in the chemotherapy group. "Gefitinib did not improve overall survival over the standard chemotherapy," said Jin S. Lee, M.D. of the National Cancer Center Korea in Goyang, Korea. "However, a promising survival outcome along with high overall response rate and better toxicity profile suggests that gefitinib might be a reasonable first-line therapy for this group of never-smoker lung cancer patients." Dr. Lee will present this study on Monday, August 3 at 9:35 am PT in Moscone West, Ballroom, Level 3. EFFICIENCY OF MAINTENANCE ERLOTINIB VERSUS PLACEBO IN PATIENTS WITH UNRESECTABLE STAGE III NON-SMALL LUNG CANCER (NSCLC) FOLLOWING CONCURRENT CHEMORADIATION (D0410, NCT00153803) (ABSTRACT # C6.1) Currently, the role of maintenance therapy following concurrent treatment with chemotherapy and radiotherapy (cCRT) in patients with unresectable stage III non-small lung cancer (NSCLC) remains undefined, and concern has been noted with maintenance therapies. To examine alternative treatment options, this trial was designed to evaluate the effectiveness of maintenance erlotinib following cCRT in unresectable stage III NSCLC patients. In this upfront, randomized, placebo-controlled phase III trial, scientists randomly assigned 243 patients with unresectable stage III NSCLC to receive erlotinib or placebo daily following their cCRT. In the intent-to-treat analysis, there was no statistically significant difference in the primary endpoint of progression-free survival (PFS). In a retrospective, subset analysis of subjects dispensed erlotinib following cCRT, their median PFS rate was 13.5 months compared to 10.4 months for subjects randomized to placebo. Furthermore, the median overall survival rate was 30.4 months for erlotinib compared to only 25.1 months for the placebo. Time to disease progression was delayed in the intent-to-treat analysis for participants randomized to erlotinib and significantly delayed in subjects dispensed erlotinib in the retrospective, subset analysis. "Based on these trends NSCLC patients exposed to maintenance erlotinib after cCRT treatment, we can conclude that this maintenance therapy may prolong disease progression," says James R. Rigas, M.D., lead author and Director of the Comprehensive Thoracic Oncology Program at Dartmouth-Hitchcock Norris Cotton Cancer Center. "While more research is needed, we are encouraged by these results and believe erlotinib could be a new maintenance therapy for high risk, stage III patients." Dr. Rigas will present this study on Monday, August 3 at 10:30 am PT in Moscone West, Room 2002-2004, Level 2. ABOUT LUNG CANCER Lung cancer is the uncontrolled growth of abnormal cells in one or both lungs. As they grow, the abnormal cells can form tumors and impede the function of the lung, which is to provide oxygen to the body via the blood. Approximately 1.3 million new cases of lung cancer will be diagnosed this year, and the disease remains the leading cause of cancer deaths worldwide. Liz Wulderk International Association for the Study of Lung Cancer

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