Trial Confirms Benefit of Targeted Combination in Lung Cancer

A large phase III study, which examined whether the addition of Tarceva (erlotinib) to Avastin (bevacizumab) delayed progression of advanced non-small cell lung cancer, reached its primary goal.

The ATLAS trial included 743 patients treated with four cycles of Avastin and randomized them to continue on Avastin with or without the addition of Tarceva. Data revealed that cancer growth was delayed for 4.8 months with the combination regimen compared with 3.7 months for Avastin alone—a 39 percent improvement. As demonstrated in previous trials, patients who were never-smokers and of Asian descent appeared to have a better response.

The trial was halted after a clear benefit was shown, and patients assigned to the Avastin-only arm were allowed to cross over to receive Tarceva. Overall survival results are expected later this year. Side effects occurred in 44 percent of patients taking Tarceva and Avastin compared with 30 percent receiving Avastin alone, with rash, diarrhea, and fatigue occurring more frequently with the combination.

The next step, researchers say, is to determine if there are biomarkers, such as epidermal growth factor receptor and KRAS mutation, which may have contributed to the success or failure of the treatment in certain patients.