Erlotinib does not improve survival in glioblastoma multiforme

NEW YORK (Reuters Health) - Erlotinib added to temozolomide and radiation therapy does not improve survival in patients with glioblastoma multiforme (GBM), according to a report in the Journal of Clinical Oncology, published October 27th ahead of print.

"Our trial found no additional benefit for erlotinib when combined with radiation therapy and temozolomide," Dr. Paul D. Brown told Reuters Health. "This result is similar to other studies that have not found epidermal growth factor receptor (EGFR) inhibitors (such as erlotinib) to be beneficial in the treatment of patients with newly diagnosed glioblastoma."

Dr. Brown from the Mayo Clinic, Rochester, Minnesota, and colleagues in the North Central Cancer Treatment Group (NCCTG) study N0177 investigated the feasibility and efficacy of combining standard radiotherapy and temozolomide with erlotinib in the treatment of newly diagnosed GBM.

The median progression-free survival was 7.2 months, and the median overall survival was 15.3 months, the authors report.

These results did not differ significantly from prior trials that combined radiotherapy with temozolomide without erlotinib.

"Despite compelling laboratory evidence that the EGFR pathway is key to glioma cell growth in many tumors, rigorous clinical trials are necessary to define the true benefit for patients," Dr. Brown said. "To further improve on temozolomide and radiotherapy in the treatment of patients with newly diagnosed GBM, future trials are needed such as those the Mayo Clinic and NCCTG are developing, targeting other signaling pathways or multiple different pathways."

Trials ongoing or under development will explore the efficacy of adding temsirolimus, everolimus, vorinostat, dasatinib, bevacizumab, and other agents to the basic radiotherapy-temozolomide regimen, Dr. Brown said.

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