Targeted therapy slows cancer progression

Drugs targeting mutations of the epidermal growth factor receptor versus chemotherapy for lung cancer

A new study has delivered evidence that a drug targeting specific genetic abnormality to block cancer growth is better than chemotherapy, in terms of progression of cancer, for patients with advanced non-small-cell lung cancer with mutations of epidermal growth factor receptor (EGFR).

The study, the largest to date, aimed to answer these important questions: do patients with specific mutations and / or clinical characteristics benefit more from an EGFR tyrosine kinase inhibitor than chemotherapy? 

This collaborative research involving researchers from Australia, Taiwan, China, Japan, Spain and the USA, analysed data from a large dataset of 1649 patients based on 7 clinical trials that randomly allocated patients to an EGFR tyrosine kinase inhibitor or combination chemotherapy. Most patients had one of the common EGFR mutations: exon19 deletion or exon 21 L858R substitutions. About two-thirds had never smoked and about two-thirds were women.

Patients on the EGFR tyrosine kinase inhibitor, overall, had a 63% benefit in terms of progression of cancer, as compared with chemotherapy. Those with the exon 19 deletions did better on the drug than the patients with the exon 21 L858R. Patients who had never smoked had more benefit from the drug than smokers or ex-smokers, and women had slightly more benefit than men.

The study, by Dr Chee Lee and colleagues, has been published in the Journal of Clinical Oncology.