Cancer Advances: News from the 2004 ASCO Annual Meeting

Drug Shows Activity in Advanced BAC

Bronchioalveolar cell carcinoma (BAC) is a rare type of non-small cell lung cancer (NSCLC) that is most common in younger, non-smoking women. The number of people diagnosed with BAC increases each year. In the largest prospective trial to date of 138 patients with advanced BAC, researchers found that a drug called gefitinib (Iressa) produced a positive response, especially in patients who had not received any prior treatment.

Gefitinib works by shutting down a protein called the epidermal growth factor receptor (EGFR), which is why it is called an EGFR inhibitor.

The results showed that cancer in 19% of the previously untreated patients responded to gefitinib, with 6% of patients experiencing a complete response, which is when all signs of cancer disappear. In patients who had already been treated with other drugs, the cancer showed a 9% response rate to gefitinib, but there were no complete responses. The median survival rate was 12 months for the previously untreated patients and 13 months for those patients who had been previously treated with other chemotherapy.

"This trial demonstrates clear, long-lasting activity for gefitinib in a minority of patients with BAC," said lead author Howard West, MD, of the Swedish Cancer Institute in Seattle, Wash. He suggested that gefitinib could become a new standard of care for patients with BAC.

Researchers also found that certain groups of patients responded differently to gefitinib. For example, women on gefitinib lived a median of 19 months, compared with an average of 8 months in men. Patients who developed a rash from gefitinib treatment lived longer (13 months) than those without a rash (5 months). Ongoing analysis of the data also suggests that patients who had never smoked live longer on gefitinib than former or current smokers. Similar results have been seen previously in other EGFR inhibitors.

Dr. West thought these results were interesting, but explained that more research needed to be done to understand why different groups of patients respond differently to the same treatment.

What This Means For Patients

These results add to existing data showing that gefitinib and drugs that target the EGFR pathway are effective in treating people with BAC. For reasons not yet understood, women, nonsmokers, and patients who develop a rash survive longer on this therapy.

*** POSTED JUNE 9, 2004 ***