A metaanalysis zuyao yang 1,2, allan hackshaw3, qi feng1, xiaohong fu1, yuelun zhang1, chen mao1,4 and jinling tang1,2,4 1 division of epidemiology, the jockey club school of public health and primary care, the chinese university of hong kong, hong kong, china 2 the hong kong branch of the chinese cochrane centre. Erlotinib in lung cancer molecular and clinical predictors. Modified indication for erlotinib in advanced nonsmall cell. Listing a study does not mean it has been evaluated by the u. Prese slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Erlotinib is a synthetic manmade oral drug that is used for treating cancer. Request pdf on nov 1, 2005, william pao and others published erlotinib in lung cancer find, read and cite all the research you need on researchgate. It is approved for treatment of nonsmall cell lung cancer nsclc there are more than 1. During erlotinib treatment, the lung adenocarcinoma progressed through two. Request pdf erlotinib in lung cancer eliezer m van allen, nikhil wagle, petar stojanov, danielle l perrin, kristian cibulskis, sara marlow, judit janevalbuena, dennis c friedrich. Erlotinib tarceva is a synthetic drug prescribed for the treatment of cancer. Costeffectiveness of three strategies for secondline.
Erlotinib is a selective epidermal growth factor receptor tyrosine kinase inhibitor. Fda approves tarceva for patients with advanced nonsmall cell lung cancer. Erlotinib for frontline treatment of advanced nonsmall cell. Jun, 2012 treatment of nonsmallcell lung cancer with erlotinib or gefitinib n engl j med. Most patients will, therefore, face the option of palliative chemotherapy rinaldi et al. Erlotinib in previously treated nonsmallcell lung cancer. Erlotinib for the treatment of nonsmallcell lung cancer. Among patients with nonsmallcell lung cancer who receive erlotinib, the presence of an egfr mutation may increase responsiveness to the agent, but it is not indicative of a survival benefit. Comparison of effectiveness of gefitinib, erlotinib, and. To receive any information on this website in an alternate format, please contact communications by phone at. Erlotinib blocks inhibits signals within the cancer cells and stops the action of a. Role of erlotinib in the treatment of nonsmall cell lung. Tarceva metastatic nonsmall cell lung cancer nsclc indication.
Your healthcare provider will perform a test to make sure that tarceva is right for you. Erlotinib hydrochloride is approved to be used alone or with other drugs to treat. Tarceva monotherapy is indicated for the maintenance treatment of patients with locally advanced or metastatic nonsmall cell lung cancer whose disease. Brain metastases from nonsmall cell lung cancer nsclc are present in 2030% of patients 1. Kinases are proteins that help control how cells grow and divide. Effect of erlotinib plus bevacizumab vs erlotinib alone on. Signs of lung or breathing problems like shortness of breath or other trouble breathing, cough, or fever.
Lung cancer continues to be the leading cause of cancer related deaths worldwide. We aimed to determine the efficacy and safety of the second, third or fourthline erlotinib in advanced nsclc patients in turkish population. Tarceva erlotinib dosage in metastatic nsclc treatment. Analysis of the australian subpopulation of the trust study. Erlotinib can be used to treat nonsmall cell lung cancer nsclc that has spread metastatic cancer. Weakness on 1 side of the body, trouble speaking or thinking, change in balance, drooping on one side of the face, or blurred eyesight. Erlotinib is an orally administered small molecular inhibitor of egfr tyrosine kinase. Importance erlotinib is a standard firstline therapy for patients with epidermal growth factor receptor egfrmutant nonsmall cell lung cancer nsclc. Treatment of nonsmallcell lung cancer with erlotinib or. The median overall survival of patients treated with firstline chemotherapy ranges. Eighty patients 33 males and 47 females were retrospectively evaluated. Phase iii trial of cetuximab and erlotinib in patients with.
The most common mechanism of acquired resistance to erlotinib is development of a secondary mutation in egfr, suggesting that these tumors continue to. Determinants of tumor response and survival with erlotinib in patients with nonsmallcell lung cancer roma. This document is about when erlotinib should be used to treat people with locally advanced or metastatic nonsmallcell lung cancer in the. After 6 rounds of radiation on my spine to defer some of the pain and 2 months in the hospital i started taking tarceva as the only option to chemo or dying within 56 months. Cancer care ontario is committed to ensuring accessible services and communications to individuals with disabilities. Erlotinib treatment trial a081105 national cancer institute. The relay regimen is a viable new treatment option. Erlotinib is a targeted therapy drug used to treat nonsmall cell lung cancer nsclc or pancreatic cancer. You may have a test to check if you are likely to benefit from erlotinib. Transformation to small cell lung cancer and activation of kras.
Interpretation ramucirumab plus erlotinib demonstrated superior progressionfree survival compared with placebo. The phase iii iressa survival evaluation in lung cancer isel trial compared gefitinib with. Erlotinib has proven to be effective for patients with more advanced stages of nonsmall cell lung cancer, and is fda approved for those patients. Estimates from the usa indicate that perpatient lung cancer management costs rose by a factor of at least five between 1991 and 2002 1, 2. Pdf efficacy of erlotinib in patients with advanced non. Pdf we conducted a randomized, placebocontrolled, doubleblind trial to determine whether the epidermal growth factor receptor inhibitor erlotinib. Lung cancer is primarily diagnosed during the advanced stage of disease, at which stage treatment options are severely limited. The treatment of patients with metastatic nonsmall cell lung cancer nsclc whose tumors have epidermal growth factor receptor. Pdf erlotinib in previously treated nonsmallcell lung cancer. The treatment of patients with metastatic nsclc whose tumors have epidermal growth factor receptor egfr exon 19 deletions or exon 21 l858r substitution mutations as detected by an fdaapproved test receiving firstline, maintenance, or second or greater line treatment after progression following at least one prior. The primary endpoint was the 1year overall survival os rate. We evaluated erlotinib in the frontline treatment of advanced nsclc and assessed biological predictors of outcome. Erlotinib monotherapy for maintenance treatment of nonsmall.
Erlotinib has proven activity in pretreated patients with advanced nonsmall cell lung cancer nsclc. Pdf erlotinib in advanced nonsmall cell lung cancer. Erlotinib is recommended as an option for treating locally advanced or metastatic nonsmallcell lung cancer that has progressed in people who. The treatment of patients with metastatic nonsmall cell lung cancer. This test is done on samples of cancer cells taken by biopsy or during surgery.
Review side effects, dosage, drug interactions, warnings and precautions, and pregnancy safety information prior to taking this medication. Erlotinib and gefitinib for treating nonsmallcell lung cancer. Rechallenge with erlotinib in osimertinibresistant lung. Erlotinib is a type of targeted therapy drug called a tyrosine kinase inhibitor. Treatment strategies for lung cancer have rapidly developed in recent years, particularly targeted therapy for nonsmall cell lung cancer nsclc patients carrying driver gene mutations. Nov 10, 2016 on october 18, 2016, the indication for erlotinib tarceva in the treatment of nonsmall cell lung cancer nsclc was modified to limit use to patients with tumors with specific epidermal growth factor receptor egfr mutations in maintenance or second or greaterline treatment.
Safety was consistent with the safety profiles of the individual compounds in advanced lung cancer. Comparison of gefitinib, erlotinib and afatinib in non. Cutaneous complications of erlotinib in the treatment of non. Stage 4 lung cancer that had got into my bones from my shoulders to my hips and spine and liver was found 562015. Nonsmall cell lung cancer nsclc that is metastatic and has certain egfr gene mutations. Nonsmall cell lung cancer nsclc tarceva monotherapy is indicated for the maintenance treatment of patients with locally advanced or metastatic nonsmall cell lung cancer whose disease. Pdf erlotinib in lung cancer molecular and clinical.
Survival benefit with erlotinib maintenance therapy in patients with. This study aims to compare the effectiveness of first line tkis. Efficacy of erlotinib in patients with advanced nonsmallcell lung cancer nsclc. In patients on maintenance therapy or whose disease has gotten worse after treatment with chemotherapy. Erlotinib in the treatment of advanced nonsmall cell lung. Erlotinib tarceva for the treatment of nonsmallcell lung. Tarceva is prescribed for patients with nonsmall cell lung cancer nsclc whose cancer has spread to other parts of the body and that has certain types of epidermal growth factor receptor egfr mutations. Efficacy and safety of erlotinib in previously treated. Shepherd and j rodrigues pereira and tudor ciuleanu and eng huat tan and vera hirsh and sumitra thongprasert and daniel campos and savitree maoleekoonpiroj and michael. Role of erlotinib in the treatment of nonsmall cell lung cancer. Ramucirumab plus erlotinib in patients with untreated, egfr. Researchers are constantly looking for better ways to treat lung cancer, to relieve symptoms, and to improve patients quality of life. Erlotinib and bevacizumab in patients with advanced nonsmall.
Lung cancer is the leading cause of cancer related death and represents a considerable public health burden worldwide. Cyp3a4 inducers decrease erlotinib plasma concentrations. Median progressionfree survival pfs with erlotinib is approximately 10 months. The firstline treatment of patients with metastatic nonsmall cell lung cancer nsclc whose tumors have epidermal growth factor receptor egfr exon 19 deletions or exon 21 l858r substitution mutations as detected by an fdaapproved test see clinical studies 14. Determinants of tumor response and survival with erlotinib in. Similarly in slovenia lung cancer ranks first in men. It is approved to treat nonsmall cell lung cancer, advanced unresectable metastatic prostate cancer, and for pancreatic cancer. Currently, erlotinib, at a standard oral daily dose of 150 mg, is licensed for the treatment of unselected recurrent nonsmall cell lung cancer nsclc patients, however, it is being investigated. Tarceva is also indicated for switch maintenance treatment in patients with locally advanced or. Treatment of nonsmallcell lung cancer with erlotinib or gefitinib. In europe lung cancer ranks first among all cancers and cancer related deaths in men and fourth in women.
Erlotinib in treating patients with advanced nonsmall cell. Prospective assessment of discontinuation and reinitiation of. Erlotinib is an orally administered small molecule inhibitor of epidermal growth factor receptor egfr tyrosine kinase. Secondline erlotinib for nonsmallcell lung cancer the lancet. Azd9291 versus gefitinib or erlotinib in patients with. Brain metastases from lung cancer responding to erlotinib. Pdf erlotinib in previously treated nonsmallcell lung. Select clinical trials of erlotinib osi774 in nonsmallcell lung. Erlotinib at the standard oral daily dose of 150mg is approved for the treatment of unselected chemorefractory advanced nonsmall cell lung cancer patients as well as maintenance therapy after firstline chemotherapy.
These new therapies may represent a significant advance in the treatment of your cancer. Shepherd and j rodrigues pereira and tudor ciuleanu and eng huat tan and vera hirsh and sumitra thongprasert and daniel campos and savitree maoleekoonpiroj and. Erlotinib or gefitinib versus placebo in second or thirdline settings. Clinical details of 3 australian patients with nonsmall cell lung cancer receiving erlotinib therapy. Dec 28, 2006 erlotinib in treating patients with advanced nonsmall cell lung cancer the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Rowinsky, mark huberman, daniel karp, james rigas, gary m. In this phase ii study, chemotherapynaive patients with stage iiibiv nsclc received oral erlotinib 150 mgd until disease progression or. Egfrtyrosine kinase inhibitors egfrtkis were used to treat nonsmall cell lung cancer nsclc patients with egfr mutation positive. Lung cancer is the leading cause of cancerrelated mortality globally. Nov 26, 2008 this guidance has been updated and replaced by erlotinib and gefitinib for treating nonsmallcell lung cancer that has progressed after prior. Nonsmall cell lung cancer nsclc accounts for about 80% of all lung cancers and approximately half of the patients present with advanced disease at the time of diagnosis yang et al. According to the national cancer institute, lung cancer is responsible for nearly 30% of cancer deaths in the us. A metaanalysis zuyao yang 1,2, allan hackshaw3, qi feng1, xiaohong fu1, yuelun zhang1, chen mao1,4 and jinling tang1,2,4 1 division of epidemiology, the jockey club school of public health and primary care, the chinese university of hong kong, hong kong, china. Lung cancer is the leading cause of cancer deaths in china and over the world, and nearly 1 million new cases are expected annually by 2025.
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