Sunitinib + Erlotinib Does Not Improves Overall Survival in NSCLC

Share this content:

(ChemotherapyAdvisor) – Triple target inhibition of EGFR, VEGFR, and PDGFR with the addition of sunitinib to erlotinib did not improve overall survival (OS) compared with erlotinib alone in patients with refractory non–small-cell lung cancer (NSCLC), but the combination was associated with a significantly longer progression-free survival (PFS) and a greater objective response rate (ORR), a study in the Journal of Clinical Oncology online May 7 concluded.

The global Phase 3 randomized trial randomly assigned 960 patients previously treated with one to two chemotherapy regimens — including one platinum-based regimen — for recurrent NSCLC, and for whom erlotinib was indicated, to sunitinib 37.5mg/day or placebo plus erlotinib 150mg/day. Patients were stratified by prior bevacizumab use, smoking history, and epidermal growth factor receptor expression.

Baseline characteristics were balanced between the two arms. Prior bevacizumab use was 9.6% in the sunitinib plus erlotinib arm and 10.4% in the erlotinib alone arm.

Median OS, the primary endpoint, was 9.0 months for sunitinib plus erlotinib vs. 8.5 months for erlotinib alone (HR, 0.922; one-sided stratified log-rank P=0.1388). Median PFS was 3.6 months vs. 2.0 months (HR, 0.807; one-sided stratified log-rank P=0.0023), and ORR was 10.6% vs. 6.9% (two-sided stratified log-rank P=0.0471), respectively.

“Never-smoking status, female sex, Asian ethnicity, ECOG PS of 0, two or fewer disease sites, and stage 3B disease were all favorable independent prognostic factors for OS by multivariate analysis,” the investigators found. “The influence of EGFR mutation or EGFR expression status could not be assessed; EGFR expression status was reported in a small number of patients (58 EGFR positive; 28 EGFR negative) because of the risks associated with collecting lung tumor tissue,” they wrote. “However, on the basis of emerging data indicating the potentially important role of molecular characterization in choosing the most appropriate targeted therapy, we strongly recommend that tumor tissue be collected for molecular analysis in future trials. Ideally, molecular profiling should occur before initiating treatment to allow a specific therapy with promising efficacy, if available, to be selected.”

Treatment-related toxicities grade ≥3 were more frequent in the sunitinib plus erlotinib arm and included rash/dermatitis, diarrhea, and asthenia/fatigue.

Abstract

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Sign Up for Free e-newsletters



Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs