In the treatment of lung cancer, Tarceva (also known as Erlotinib) and Iressa (also known as Gefitinib) are relatively new medications which have been a wonderfully welcome new addition to the weapons available to us in the fight against this difficult disease. A key question has been: What do we do when one of these agents stops working? Well, a group in Shizuoka, Japan, in a recent article published June 21, 2009 in the medical journal entitled Lung Cancer, has asked and has tried to answer exactly such a question.
Doctors Kaira, Naito and colleagues from the Division of Thoracic Oncology of the Shizuoka Cancer Center in Shizuoka Japan studied the results of studies performed with 106 patients who were treated with Erlotinib (Tarceva) or Gefitinib (Iressa) between November 2004 and December of 2008. What Drs. Kaira and colleagues discovered is that for patients who were initially treated with Gefitinib (Iressa) and who showed a response to treatment with Gefitinib by stopping the growth of their tumors for approximately 6 months while they were receiving Gefitinib (Iressa) treatment, then showed a good response to treatment with Erlotinib (Tarceva), if they received treatment with Erlotinib (Tarceva) after the Gefitinib (Iressa) stopped working for them.
These are exciting results. What these results indicate is that for patients who have been receiving treatment for their lung cancers with Gefitinib (Iressa) and for whom Gefitinib stops working (and this is proven by seeing on x rays and on CAT Scans that the person’s cancer has started to grow even as the treatment with Gefitinib was ongoing), it makes sense to then switch to treatment with Erlotinib (Tarceva) at that point. These researchers have shown that treatment with Erlotinib (Tarceva) after 6 months of prior treatment with Gefitinib (Iressa) (especially if the Gefitinib was working for those previous 6 months) is beneficial. Moreover, it was shown that the side effects of these medications were very mild. The only real side effects were a mild skin rash and sometimes loose stools. Both of these side effects can be readily treated.
In summary, for patients who have been receiving therapy with Gefitinib (Iressa) and who have seen their cancers remain stable and not grow for a good 6 months while on treatment with Gefitinib (Iressa), if they then are told that their cancers have now started to grow even as the treatment with Gefitinib (Iressa) is ongoing, a reasonable treatment consideration at that point, in light of the results of the study by Drs. Kaira and colleagues mentioned above, is to then move on to treatment with Erlotinib (Tarceva).
All of the above concepts and principles are covered in very easy to understand language in the Lung Cancer audio CD available on the web site www.CancerInPlainEnglish.com