Combination of carboplatin and paclitaxel with bevacizumab and cetuximab proves safe for lung cancer treatment
Clinicians using an electronic prescribing system appear more likely to prescribe lower-cost medications, reducing drug spending, according to a report in the December 8/22 issue of Archives of Internal Medicine. “Prescription drug costs account for a significant proportion of medical spending and have been increasing rapidly,” the authors write as background information in the article.
Full Post: Electronic prescribing system may encourage physicians to prescribe lower-cost medications
The four drug-combination of carboplatin and paclitaxel, with the targeted therapies bevacizumab (Avastin) and cetuximab (Erbitux), is safe and may improve survival for patients with advanced lung cancer, according to a cooperative group study led by The University of Texas M. D. Anderson Cancer Center.
Presented today on the press program of the 2008 Chicago Multidisciplinary Symposium in Thoracic Oncology, sponsored by ASTRO, ASCO, IASLC and the University of Chicago, the study is the first to investigate in lung cancer a four-drug regimen of two standard chemotherapies and targeted therapies.
The Southwest Oncology Group (SWOG) Phase II study was led by Edward S. Kim, M.D., assistant professor in M. D. Anderson’s Department of Thoracic Head and Neck Medical Oncology. Until now, the SWOG standard regimen for lung cancer has been carboplatin, paclitaxel and Erbitux, explained Kim; with the addition of Avastin, this study looked to increase efficacy without compromising safety.
“We could not conduct a study with four chemotherapeutic agents in patients due to toxicity concerns,” said Kim, the study’s principal investigator. “The rationale behind the study was the finding that Avastin enhances the efficacy of existing therapy, thereby possibly improving the carboplatin-paclitaxel-Erbitux regimen.”
Data in lung cancer has also suggested there’s a “synergistic effect” of pairing the epidermal growth factor (EGFR) inhibitor compounds with the vascular endothelial growth factor (VEGF) inhibitor, explained Kim.
Interestingly, explained Kim, the SWOG’s study came at a crossroads for lung cancer - soon after a study was presented showing the benefits of adding Avastin to standard chemotherapy, and prior to a study showing a modest survival benefit when Erbitux is combined with chemotherapy.
Between August 2006 and September 2007, the large Phase II study enrolled 110 Stage IIIB or IV non-small cell lung cancer patients, 99 of whom were able to be evaluated. Patients received six cycles of the four-drug regimen, and as maintenance, continued receiving both Avastin and Erbitux. It’s unique for a trial to feature a two-drug maintenance biologic therapy combination, explained Kim.
The study met its primary endpoint, safety, defined by frequency of pulmonary hemorrhage, or bleeding, a concern related to Avastin. There were four treatment-related deaths and two due to bleeding, which is consistent with prior Avastin studies, explained Kim. Adverse events such as low blood counts and neuropathy were reported in 40 patients, also consistent with standard chemotherapy.
Secondary endpoints included response rate, progression-free survival and overall survival. Of patients enrolled, 53 percent had shrinkage of their tumors and 24 percent had stable disease. The median progression-free survival rate was seven months and overall survival was 14 months. In contrast, previous SWOG studies showed an average progression-free survival rate of five-and-a-half months and overall survival of 12 months.
“These findings were certainly compelling, and are the best results ever for a SWOG-based study for advanced lung cancer. While early, this four-drug combination seems to show promising, yet modest improvement in efficacy without compromising patients’ safety,” said Kim. “Our next priority will be to analyze the tissue from this to study to help find appropriate biomarkers for the disease to best understand who might benefit from this drug regimen.”
A biomarker analysis of this study is ongoing and a randomized Phase III study is planned, with the trial scheduled to open in 2009.
The combination of traditional chemotherapy agents with targeted therapies called monoclonal antibodies showed no safety concerns and improved survival in patients with advanced non-small cell lung cancer according to a study presented at the 2008 Chicago Multidisciplinary Symposium in Thoracic Oncology, sponsored by ASTRO, ASCO, IASLC and the University of Chicago. The combination of bevacizumab
Full Post: Traditional chemotherapy agents with targeted therapies improves survival in advance-stage lung cancer
Biothera has announced today it began dosing patients in the second arm of its metastatic colorectal cancer (mCRC) trial in August. This arm of the trial is evaluating the combination therapy of its lead drug candidate, Imprime PGG, with Erbitux, an anti-cancer monoclonal antibody from ImClone Systems. Unlike the first trial arm, the second treatment
Full Post: Biothera initiates second phase of metastatic colorectal cancer trial
Gefitinib, also known as Iressa, the once-promising targeted therapy for the treatment of non-small cell lung cancer, has proven as effective as chemotherapy as a second-line therapy for the disease with far fewer side effects, according to an international Phase III clinical trial, led by researchers at The University of Texas M. D. Anderson Cancer
Full Post: Gefitinib just as effective as chemotherapy for lung cancer
Epeius Biotechnologies announced today the results of Phase I/II and II studies of Rexin-G in chemotherapy-resistant metastatic soft tissue sarcoma and osteosarcoma, as presented by Dr. Sant P. Chawla, principal investigator, at the CTOS 14th annual meetings held in London UK on November 13-15, 2008. Patients received repeated infusions of Rexin-G i.v. over a period
Full Post: Epeius Biotechnologies announces results of Rexin-G in chem-resistant metastatic soft tissue sarcoma and osteosarcoma
NovoCure Ltd. presented results yesterday evaluating the Novo-TTF device in vitro and in a pilot clinical trial that showed the device enhanced the efficacy of standard chemotherapy (temozolomide) treatment in newly-diagnosed glioblastoma multiforme (GBM) patients. When used in combination with standard chemotherapy, the Novo-TTF, a non-invasive medical device that uses low intensity alternating electric fields
Full Post: Novel device enhances efficacy of standard chemotherapy