Interested in finding more info on targeted chemo tablets, Iressa and Tarcevaa.

[lynnn]

Is everybody with NSLC tested ? If so how are they tested? Our oncologist has recommended carboplatin/gemcitabine chemotherapy up to 4 cycles and might consider local radiotherapy, if there is a response to chemo. He has just completed his first cycle of chemo but just wondering if these targeted chemo tablets would be a better option or could it be beneficial to have these as a 2nd line of treatment following his full planned treatment. Confused!

[Hidden]

Hi Lynn

From what I am told, everyone in the UK who is diagnosed with lung cancer where a biopsy/specimen is obtained is tested routinely for the EGFR genetic mutation. There are only 10% of the Caucasian population who have it (40% if you are asian). You are more likely to have it it you are a female and a non smoker.

Iressa and Tarceva are TKI's ( Tyrosine Kinase Inhibitors) and are essentially the same, however there is a difference. Iressa works predominantly on the tumour and less on the blood supply to the tumour, therefore if you are EGFR positive has great results. It is only given as a first line treatment. Tarceva however is the opposite working predominantly on the blood supply and less on the tumour, this is why Tarceva has sometimes worked well in patients who are not EGFR positive as a second line treatment.

Hope that helps

Lyn x

[lynnn in reply to Hidden]

Hi Lyn

Thank you for responding to my question, everything is much clearer now with regards to this subject.

Hope to speak to you again soon

Lyn

[LorraineD Partner Roy Castle in reply to lynnn]

In response to the post above (posted by Lynn on the 21st August), I want to clarify a number of points regarding the differences between Tarceva and Iressa.

Tarceva (erlotinib) and Iressa (gefitinib) act by blocking the EGFR receptor and thus prevent signalling that causes the inappropriate cell growth that is cancer. Tarceva does not target the blood supply to the tumour.

Both medicines are approved for use as first line treatment in patients who have EGFR mutations. Unlike Iressa, Tarceva is also approved for use in patients with or without EGFR mutations in the following settings:

o Treatment of locally advanced or metastatic (spreading through the body) non-small cell lung cancer (NSCLC), whose cancer has worsened following at least one prior chemotherapy regime.

o Maintenance treatment in people with advanced NSCLC whose disease remains largely unchanged after 4 cycles of initial chemotherapy (known as stable disease)

As Lynn highlights, certain groups have a higher prevalence of EGFR mutations. As well as women and non-smokers, people who have the form of NSCLC known as adenocarcinoma (a type of lung cancer that begins in the lining of the airways) are also more likely to have the mutation. Also, current evidence suggests that the rate of EGFR mutations in the Asian population is 30%.

I hope this information is helpful.

Medical Affairs Team, Roche Oncology