For the last week, I have been feverishly working on a feature article that is sure to pique your interest. The article focuses on the lack of use of biologics in the treatment of lung cancer.

Now, it is not news that lung cancer is the deadliest cancer in the United States. In fact, a recent report from the American Cancer Society estimates that there will be a total of 226,160 newly diagnosed cases of lung cancer in the US in 2012; of these, 160,340 will die of the disease.

With statistics like these, why is there not a continuous flow of new therapeutics in the pipeline? How long will lung cancer patients have to endure treatment with toxicity-inducing platinum-based drugs, which are the standard of care for lung cancer?

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It is no surprise that there is so much toxicity associated with platinum-based drugs—their specificity is inadequate. Thus, the need for a larger number of highly targeted lung cancer therapies is clear, and that unmet medical need might be satisfied by the use of biologics in the treatment of lung cancer.     

The clinical outcomes on the use of biologics in the treatment of lung cancer have been disappointing. Several clinical trials have demonstrated this fact. However, no one trial has demonstrated a consistent benefit for biologics, thus continuing the challenges to their acceptance as a first-line therapy for this deadly disease. In my upcoming feature article, which will be published on August 30, I will present clinical trials of two biologics: bevacizumab (Avastin®, Genentech) and cetuximab (Erbitux®, Eli Lilly and Company).

One clinical trial examined whether adding bevacizumab to the standard of care chemotherapy (carboplatin and paclitaxel) would improve survival in elderly patients (age ≥ 65 years) with non-small cell lung cancer (NSCLC). Data from 3 cohorts of patients diagnosed with stage IIIB or stage IV NSCLC failed to demonstrate statistically significant differences in survival rates after treatment with either bevacizumab-carboplatin-paclitaxel or carboplatin-paclitaxel combination therapy. These findings led the investigators to conclude that adding bevacizumab to carboplatin and paclitaxel chemotherapy does not prolong survival for patients with advanced NSCLC.

Another trial compared the safety and efficacy of first-line bevacizumab in combination with standard chemotherapy in patients aged < 65 years vs. patients aged ≥ 65 years, with advanced or recurrent NSCLC. This trial demonstrated that, for both age groups, adding bevacizumab to standard chemotherapy prolongs survival with minimal toxicity. 

  • What is your opinion of the use of biologics in the treatment of lung cancer?

Take the poll:

Would you consider using a biologic as a first-line therapy for the treatment of your lung cancer patients?