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. 2010 Jun 1:2:143-56.
doi: 10.2147/cmar.s5398.

Role of erlotinib in first-line and maintenance treatment of advanced non-small-cell lung cancer

Noemí Reguart  1 , Andrés Felipe Cardona, Rafael Rosell
Affiliations

Role of erlotinib in first-line and maintenance treatment of advanced non-small-cell lung cancer

Noemí Reguart et al. Cancer Manag Res. .

Abstract

Erlotinib hydrochloride (Tarceva(®)) is a member of a class of small molecule inhibitors that targets the tyrosine kinase domain of the epidermal growth factor receptor (EGFR), with anti-tumor activity in preclinical models. Erlotinib represents a new-generation of agents known as "targeted therapies" designed to act upon cancer cells by interfering with aberrant specific activated pathways needed for tumor growth, angiogenesis and cell survival. Since its approval in November 2004 for the treatment of locally advanced or metastatic non-small cell lung cancer (NSCLC) after the failure of at least one prior chemotherapy regimen and with a view to improving patients' outcomes and prevent symptoms, the scientific community has evaluated the potential role of erlotinib in other scenarios such as in maintenance therapy and, in first-line setting for a selected population based on biological markers of response such as mutations of the EGFR. The convenient once-a-day pill administration and the good toxicity profile of erlotinib make it a reasonable candidate for testing in this context. This report provides a review of the role of erlotinib therapy in advanced NSCLC. It summarizes current data and perspectives of erlotinib in upfront treatment and maintenance for advanced NSCLC as well as looking at candidate biomarkers of response to these new targeted-agents.

Keywords: erlotinib; first line; maintenance; non-small-cell lung cancer; tyrosine kinase inhibitors.

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Figures

Figure 1
Figure 1
Erlotinib hydrochloride molecule: N-(3-ethynylphenyl)-6,7-bis(2-methoxyethoxy)-4-quinazolinamine; C22H23N3O4.HCl; MW 429.90.
Figure 2
Figure 2
Design of the phase III trial of erlotinib in first-line advanced NSCLC with EGFR mutations in Europe: the EURTACC trial. Abbreviations: ECOG, Eastern Oncology Cooperative Group; EGFR, epidermal growth factor receptor; NSCLC, non-small-cell lung cancer; ORR, objective response rate; PD, progressive disease; QoL, quality of life.
Figure 3
Figure 3
Design of the phase III trial of erlotinib in first line advanced NSCLC with EGFR mutations in Asian population: the OPTIMAL trial. Abbreviations: ECOG, Eastern Oncology Cooperative Group; EGFR, epidermal growth factor receptor; NSCLC, non-small-cell lung cancer; PD, progressive disease; PFS, progression-free survival; ORR, overall response rate; OS, overall survival; QoL, quality of life.
Figure 4
Figure 4
Current strategies to treat advanced NSCLC patients. Abbreviations: NSCLC, non-small-cell lung cancer; PD, progressive disease; CR, complete response; PR, partial response; SD, stable disease.
Figure 5
Figure 5
Design of erlotinib maintenance phase III trials in advanced NSCLC treatment (SATURN and ATLAS74). Abbreviations: NSCLC, non-small cell lung cancer; non-PD, complete responses, partial responses, stable disease; PD, progressive disease; PFS, progression-free survival.
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