Gene Mutation Improves Response to Lung Cancer Drug

Aug. 20 -- WEDNESDAY, Aug. 19 (HealthDay News) -- People with lung cancer who are screened for a genetic mutation and then given a drug called Tarceva, which is believed to work well with that mutation, live longer than those without the mutation who take the drug, new research has found.

According to the Spanish authors of a study in the Aug. 20 issue of the New England Journal of Medicine, this type of widespread screening is actually doable and could lead to better decisions about treatment.

"They proved that it is worthy to test patients for the [epidermal growth factor receptor gene] mutations, and that if you have the mutations you are going to do well," said Dr. Edgardo Santos, an assistant professor of medicine in the hematology and oncology section at the University of Miami's Sylvester Comprehensive Cancer Center. "If we are moving toward personalized medicine in the future, I think this is the way to go -- that patients be tested and use the drug if indicated."

People who have advanced non-small-cell lung cancer who also have certain mutations in the epidermal growth factor receptor gene (EGFR) tend to respond better to Tarceva and Iressa. Both of these drugs are tyrosine kinase inhibitors, which interfere with cancer cells' ability to multiply. Non-small-cell lung cancer is the most common form of lung cancer.

The researchers screened lung cancer samples from 2,105 people at 129 institutions in Spain for two different EGFR mutations.

Those with mutations (16.6 percent of the sample, considered a sizable proportion) were put on Tarceva. They survived a median of 14 months without progression of their disease and 27 months overall, more than twice as long as the rates seen in other treatment groups, Santos said. This was true regardless of whether Tarceva was given as first-line, second-line or third-line therapy.

"Basically, this highlights the fact that patients with EGFR mutations should, sometime during the course of their illness, get erlotinib [Tarceva]," said Dr. George Simon, director of thoracic oncology at Fox Chase Cancer Center in Philadelphia. "However, I think for reasons of quality of life and ease of administration and differences in toxicity profiles, it may still be preferable to give gefitinib [Iressa] first-line."