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No Progression-Free or Overall Survival Benefit With Second- or Third-Line Erlotinib vs Docetaxel in EGFR-Unselected Japanese NSCLC Patients

No Progression-Free or Overall Survival Benefit With Second- or Third-Line Erlotinib vs Docetaxel in EGFR-Unselected Japanese NSCLC Patients | Lung Cancer Dispatch | Scoop.it

"In a Japanese phase III trial (DELTA) reported in the Journal of Clinical Oncology, Kawaguchi et al found that erlotinib (Tarceva) was associated with no progression-free survival or overall survival advantage as second- or third-line therapy in EGFR-unselected patients with non–small cell lung cancer.


"In this open-label trial, 301 patients with stage IIIB or IV NSCLC, previous treatment with one or two chemotherapy regimens, evaluable or measurable disease, and Eastern Cooperative Oncology Group (ECOG) performance status of 0 to 2 were randomly assigned between August 2009 and July 2012 to erlotinib at 150 mg daily (n = 150) or docetaxel at 60 mg/m2every 3 weeks (n = 151). The primary endpoint was progression-free survival. In total, 109 patients (73%) in the erlotinib group and 90 (60%) in the docetaxel group had EGFR wild-type disease. Study treatment was third line in 19% and 14%, respectively."


Editor's note: This clinical trial tested a drug called erlotinib (brand name Tarceva), which is already known to be an effective treatment for lung cancer patients whose tumors have mutations in the EGFR gene. However, in this trial, the scientists were interested in whether erlotinib might help all patients, regardless of whether EGFR is mutated. The results show that erlotinib is no more effective than chemo for patients without EGFR mutations. But we recently posted another story about a protein test that may predict whether a patient without EGFR mutations might benefit from erlotinib treatment: http://www.cancercommons.org/news/proteomic-signature-for-egfr-inhibitor-therapy-predicts-survival-benefit-of-second-line-chemotherapy-vs-erlotinib-in-nsclc/.

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The ASCO Post  |  May 27, 2014

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Colorado Medicare Will Cover VeriStrat Test for Guiding Lung Cancer Treatment

Colorado’s Medicare provider has announced that it will cover VeriStrat, a test designed to guide decisions about second-line therapies for advanced non-small cell lung cancer (NSCLC). The main second-line therapy options in NSCLC include chemotherapy or the drug erlotinib (Tarceva). While Tarceva can significantly improve outcomes in patients with mutations in the EGFR gene, it also benefits some patients without these mutations. VeriStrat, a rapid blood test, helps predict which of these patients would be more likely to respond to Tarceva and which would be better served by other treatments. Medicare coverage will allow many more patients in Colorado to access this useful tool.

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Fort Mill Times | June 20, 2013

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VeriStrat Test Can Predict Lesser Response to Tarceva

VeriStrat Test Can Predict Lesser Response to Tarceva | Lung Cancer Dispatch | Scoop.it

EGFR inhibitors like erlotinib (Tarceva) can greatly benefit non-small cell lung cancer (NSCLC) patients with mutations in the EGFR gene, but their effectiveness in patients without such mutations is less clear. VeriStrat is a blood test meant to predict how well patients would respond to EGFR-inhibitor treatment. A study designed to evaluate VeriStrat examined patients with advanced NSCLC without EGFR mutations in whom platinum-based chemotherapy had stopped working and who received either different chemotherapy or Tarceva as their second-line treatment. Patients with a VeriStrat result of 'poor' survived longer when treated with chemotherapy than with Tarceva. In contrast, chemotherapy and Tarceva worked equally well for those with a 'good' test result. Good VeriStrat results also predicted longer survival in general.

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ASCO Post | Aug 21, 2013

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VeriStrat Status Predicts Responsiveness to Tarceva Treatment in Elderly Lung Cancer Patients

VeriStrat® is a blood test for advanced non-small cell lung cancer (NSCLC) patients intended to determine whether the patients would benefit from erlotinib (Tarceva) treatment. A retrospective analysis of blood samples from elderly patients (age 70+ years) with advanced NSCLC who had been treated with either Tarceva, gemcitabine (Gemzar), or both found that patients with a "good" VeriStrat result had better outcomes than those with a "poor" result when given Tarceva either alone or in combination with Gemzar; the benefits of Gemzar alone were unaffected by VeriStrat status. The study authors conclude that elderly patients with "poor" VeriStrat results should be treated with Gemzar, while first-line Tarceva treatment may be appropriate for patients with "good" Veristrat results.

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Journal of Thoracic Oncology | Jan 30, 2013

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