Targeted cancer drug Erlotinib has comparable efficacy to chemotherapy, and is better tolerated, in hard-to-treat cases where a patient's cancer has progressed quickly after treatment with first-line therapy, new trials have found.
The study included only those patients whose disease had progressed under first-line chemotherapy.
"These patients have an extremely poor prognosis and few treatment options. An effective alternative to chemotherapy is therefore very important, since chemo-related side-effects can result in further physical deterioration in patients who are already very sick," said Tudor Ciuleanu from the Institute of Oncology Ion Chiricuta, Cluj-Napoca, Romania.
Historically, data has shown that Erlotinib was more tolerable than chemotherapy, but many physicians had assumed that Erlotinib would not be as effective in this difficult-to-treat patient population compared to chemotherapy.
The open-label study included 424 patients whose lung cancer had progressed rapidly after treatment with first-line chemotherapy. Of these, 203 were treated with erlotinib, and 221 received chemotherapy with either docetaxel or pemetrexed.
No difference in overall survival was seen between the two groups, the researchers reported. Nor was there any significant difference in progression-free survival time.
"TITAN is important because it confirms that erlotinib has comparable efficacy to chemotherapy with better tolerability, even in this population of patients with poor prognosis," said Ciuleanu.
"The study included a broad, unselected population, showing that patients can benefit from erlotinib regardless of their EGFR mutation status. Erlotinib therefore gives doctors an effective alternative to chemotherapy after disease progression, without chemo-related side-effects," added Ciuleanu.
The findings were discussed at the international TITAN study at the European Multidisciplinary Conference in Thoracic Oncology in Lugano, Switzerland.