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Drug Combinations and Treatment Strategies
Even in lung cancer patients who initially show a good response to treatment, most will eventually experience a relapse of their cancer. For this reason, researchers and clinicians are exploring new treatments and therapy combinations to try to attack the cancer from different directions.

One treatment strategy being investigated is simultaneously targeting both VEGF and the epidermal growth factor receptor (EGFR). EGFR is an important stimulator of both tumor growth and angiogenesis in many cancer types, including NSCLC.

One of the first large studies to use this treatment strategy, called BETA Lung, evaluated the anti-EGFR drug erlotinib (Tarceva®) with or without bevacizumab as second-line therapy in NSCLC patients who had received no prior anti-VEGF or anti-EGFR therapy.5 Although patients who received the bevacizumab/erlotinib combination did not live longer compared with patients who got erlotinib alone, progression-free survival time was doubled.

In a second phase 3 trial, called ATLAS, patients who were treated with bevacizumab and erlotinib following chemotherapy lived about a month longer without their disease getting worse than patients who got bevacizumab alone.6 Overall survival time was not significantly improved.

Promising results were reported from a phase 2 study that combined chemotherapy with both bevacizumab and the anti-EGFR antibody agent cetuximab (Erbitux®).7 In this study, 54% of patients had at least partial tumor shrinkage, while progression-free survival and overall survival times were about 7 months and 14 months, respectively. The surprisingly positive results from this study have led to the initiation of phase 3 trials using this treatment approach.


Last updated July 15, 2011