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Relapsed advanced non-small cell lung cancer (NSCLC) carries a dismal prognosis and new treatments are particularly welcome. These papers evaluate the use of erlotinib, a tyrosine kinase inhibitor of the epidermal growth factor receptor (EGFR) in patients with NSCLC that has advanced despite prior chemotherapy.
The study was double blind and 731 patients with good performance status who had had at least one prior course of chemotherapy were randomised to receive either oral erlotinib or placebo. In the treated group overall survival was improved by 2 months (6.7 months v 4.7 months, p<0.001). Factors predicting response to treatment were being a non-smoker, adenocarcinoma on histology, and expression of EGFR in biopsy specimens. Survival was not affected by EGFR receptor expression or EGFR mutations. This is the first study to demonstrate a survival advantage with an oral tyrosine kinase inhibitor of EGFR. Further studies investigating the use of these agents in early lung cancer are now warranted.
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