In findings doctors say could save the lives of thousands of lung cancer patients a year, two new studies reported here Saturday show that giving chemotherapy after surgery for early-stage lung cancer boosts survival.
And another report found that an experimental pill called erlotinib could offer some help to patients with advanced lung cancer who have run out of conventional treatment options.
An estimated 174,000 Americans are diagnosed with lung cancer each year, about 80 percent of them with a type called non-small cell lung cancer that was studied in all three new trials. Lung cancer is the nation's top cancer killer.
Treatment change urged
Generally, patients who undergo surgery for early-stage lung cancer are given no additional treatment afterward. But the new findings, presented at the annual meeting of the American Society of Clinical Oncology, demonstrate that adding chemotherapy to their treatment plan “should now become the standard of care,” said Dr. Frances Shepherd, a professor of medicine at the University of Toronto and chief of lung cancer research at Princess Margaret Hospital. She was not involved in the studies.
Of all patients with non-small cell lung cancer, about 30 percent are diagnosed with early-stage disease and could potentially benefit from the new results, experts said.
One trial of 482 patients with early-stage lung cancer who were followed for five years after surgery found that a chemotherapy regimen of cisplatin and vinorelbine resulted in a 15 percent improvement in survival over patients who were not treated. Sixty-nine percent of patients in the treatment group were alive at the end of the study, compared with 54 percent of the other group, reported Dr. Timothy Winton of the National Cancer Institute of Canada in Edmonton.
A second study led by Dr. Gary Strauss of Brown Medical School in Providence, R.I., involved 344 patients followed for four years after surgery. Results showed that a combination of the chemotherapy drugs paclitaxel and carboplatin resulted in a 12 percent improvement in survival over patients who were not treated. Seventy-one percent of patients in the chemotherapy group survived, compared with 59 percent in the other group.
Though improvements in survival of 12 to 15 percent may not seem huge, the benefits could actually be quite significant because so many people develop lung cancer, said Dr. Bruce Johnson, a lung cancer specialist at Harvard Medical School in Boston and an ASCO spokesperson.
As a result, thousands of patients a year could be cured by this, he said.
Potential option for advanced cancer
And in a finding that doctors say shows early promise for patients with advanced lung cancer, Shepherd and her team reported that an experimental cancer pill called erlotinib (Tarceva) extended by a median of two months the lives of patients who had failed all standard chemotherapy.
For these patients, erlotinib “prolongs lives, improves symptoms and does it with minimal toxicity –- nowhere near the side effects associated with chemotherapy,” Shepherd said. The main side effects with erlotinib were a rash and diarrhea.
“Not only did our patients live longer but I like to say they lived better,” she said, noting that patients given the drug had less cough, shortness of breath and pain than those given placebo.
Erlotinib, co-developed by OSI Pharmaceuticals, Roche and Genentech, works by inhibiting an enzyme called epidermal growth factor receptor, or EGFR, that is involved in the growth of some cancers.
In the study of 731 patients, those receiving erlotinib survived a median of 6.7 months, compared with 4.7 months for those on placebo. After one year, 31 percent of those in the treatment group were alive, compared with 22 percent of the other group.