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Drug combo shows promise for advanced lung cancer
Source: (cancerfacts.com)
Thursday, June 01, 2006
LOS ANGELES – June 1, 2006 – An early stage study pairing an experimental targeted therapy with a common anti-inflammatory drug increased the tumor response three-fold in patients with advanced lung cancer, say researchers.
Led by Dr. Karen Reckamp, an assistant professor of hematology/oncology at the University of California at Los Angeles, the researchers found that response rates in lung cancer patients increased from 10 percent for those treated with the targeted oral chemotherapy drug Tarceva® alone to 33 percent in patients treated with a combination of Tarceva and the anti-inflammatory drug Celebrex®.
"Tarceva alone is a great drug and has a lot of clinical benefits, but for a small proportion of patients," Reckamp said in a prepared statement. "With this drug combination, we saw an increase in response rates, indicating we are overcoming some resistance. We also may be beginning to understand the mechanisms of that resistance."
Volunteers in the small early study, with advanced lung cancer that had failed to respond to all conventional therapies, took several Celebrex pills and one Tarceva pill each day. After eight weeks, researchers looked at response rates, which is a measure of how well the therapy works to shrink tumors or halt their growth.
Typically, about 10 percent of lung cancer patients respond to Tarceva. In this study the combination therapy increased the number of patients who achieved a tumor response to about 33 percent. It should be noted that response rate does not correspond to survival. This study is too preliminary to have generated any data regarding its effect on survival.
Patients were able to stay on the study as long as they didn't experience tumor growth. The longest duration response was 93 weeks, Reckamp said, about three to four times longer than the average duration of response for patients with advanced lung cancer. The research appears in the June 1 issue of Clinical Cancer Research.
Previous laboratory studies at UCLA showed that a cell mechanism known as COX-2 signaling pathway may be linked to tumor resistance to drugs like Tarceva, which block tumor cell growth by targeting the protein EGFR, or epidermal growth factor receptor. Researchers theorized that giving Tarceva with Celebrex, a COX-2 inhibitor, would reduce resistance and improve the effectiveness of Tarceva against lung cancer.
The biology of an individual's tumor determines whether they will respond to Tarceva, and about 90 percent of patients don't respond to it, however researchers don't yet fully understand what biologic characteristics determine response. This means they can't test patients first to determine who should be given the drug. Reckamp said a portion of those may now be able to take Tarceva combined with Celebrex.
Because they target what is broken in a cancer cell and leave the healthy cells alone, therapies like Tarceva cause fewer side effects than conventional therapies such as chemotherapy, which targets all fast growing cells and often results in debilitating side effects. Reckamp characterized the side effects seen with the combination therapy as minor.
The research team's next step is a larger study to confirm the effectiveness of the combination therapy and further probe the mechanisms of Tarceva resistance, Reckamp said. That study is expected to begin at UCLA in the fall.
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