Erlotinib, gefitinib worthy of first-line status in some cases of NSCLC

Two chemotherapy drugs currently indicated for second- and third-line therapy in persons with advanced non-small-cell lung cancer (NSCLC) appear to be “remarkably effective” in treating a certain subset of these patients, according to a statement issued by Louisiana State University (LSU) Health Sciences Center in New Orleans.

LSU oncologist Vince D. Cataldo, MD, is the lead author of a review article featuring the two agents—erlotinib and gefitinib (N Engl J Med. 2011;364[10]:947-955). He and his multicenter team contend that these drugs should be considered as a first-line treatment for patients with NSCLC who are known to carry an epidermal growth factor receptor (EGFR) mutation.

“Targeting the genetic mutation contributing to the development of the cancer, this class of drugs produced a response rate that exceeded 70% in these patients,” remarked Dr. Cataldo in the LSU statement.

EGFR has a role not only in cell survival and cell growth, but also in the development of a nourishing blood supply and metastasis. Erlotinib and gefitinib, which are part of a class of highly specific, small-molecule tyrosine kinase inhibitors, block EGFR activation.

The side-effect profile of these medications is also noteworthy: Unlike traditional cytotoxic agents, erlotinib and gefitinib do not typically cause myelosuppression, neuropathy, alopecia, or severe nausea.

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