Test shows when pills help lung cancer patients
*Test shows 71 pct of patients with mutation benefit
*Could return Iressa to US market
By Maggie Fox, Health and Science Editor
WASHINGTON, May 14 (Reuters) - A test that looks for a certain mutation in tumors can predict which lung cancer patients will be helped by targeted pills such as Iressa and Tarceva, researchers reported on Thursday.
The study, to be presented at a meeting of the American Society of Clinical Oncology, should help doctors better choose patients who can take the pills, outside experts said.
AstraZeneca Inc. (AZN.L) stopped most U.S. sales of Iressa, known generically as gefitinib, in 2004 after it was found to help only about 10 percent to 15 percent of cancer patients.
But it has followed up on tantalizing evidence that some people -- notably non-smokers, Asians and women -- did better on Iressa.
Dr. Masahiro Fukuoka of Kinki University in Osaka, Japan and Dr. Tony Mok of the Chinese University of Hong Kong and colleagues tested tissue samples from 683 patients with non-small-cell lung cancer, the most common type.
Iressa and Tarceva, known generically as erlotinib and made by Genentech, now owned by Roche AG (ROG.VX), are monoclonal antibodies -- genetically engineered immune system molecules that target a molecule called epidermal growth factor receptor or EGFR. Tumors use EGFR to grow themselves blood supplies.
Such targeted therapies have far fewer side effects than standard chemotherapy and because they are pills and are convenient to take.
"Those drugs, while commercially available and widely used, are only modestly effective if you just give them to any old patient," Dr. Richard Schilsky, president of the American Society of Clinical Oncology and blood cancer specialist at the University of Chicago, said in an interview.
HIGH RESPONSE
Mok's and Fukuoka's study showed Iressa worked in 71 percent of patients who had the EGFR mutation, versus 43 percent of those who did not have it.
"All patients with lung cancer need to have their tumors tested for EGFR," Schilsky said. "Those who have abnormalities (in EGFR) are best treated with drugs like Iressa or Tarceva." Those who do not have the mutations will benefit best from standard chemotherapy, he said.
The study was done in non-smokers, but would likely apply to smokers who have EGFR mutations, Schilsky said -- adding that most do not.
Iressa may make a comeback in the United States if coupled with an EGFR test, Schilsky said.
More details of the study will be released at ASCO's annual meeting later this month but a summary of the findings, called an abstract, was released ahead of the meeting on Thursday.
Last month the European Medicines Agency recommended approval of Iressa, a recommendation usually followed by the European Commission.
Roche has said it will start a new trial for Tarceva in lung cancer patients with EGFR mutations.
Lung cancer kills 1.2 million people a year and is the top cause of cancer death globally. Many drugs are used to treat it but almost always stop working eventually, in part because most patients are not diagnosed until tumors have spread.
Chemotherapy, infused over a period of several hours, targets rapidly growing cells and thus often has severe side effects such as nausea, diarrhea and hair loss.
Companies such as Genzyme Corp. (GENZ.O) now market tests that show whether cancer patients have the EGFR mutation.
*Could return Iressa to US market
By Maggie Fox, Health and Science Editor
WASHINGTON, May 14 (Reuters) - A test that looks for a certain mutation in tumors can predict which lung cancer patients will be helped by targeted pills such as Iressa and Tarceva, researchers reported on Thursday.
The study, to be presented at a meeting of the American Society of Clinical Oncology, should help doctors better choose patients who can take the pills, outside experts said.
AstraZeneca Inc. (AZN.L) stopped most U.S. sales of Iressa, known generically as gefitinib, in 2004 after it was found to help only about 10 percent to 15 percent of cancer patients.
But it has followed up on tantalizing evidence that some people -- notably non-smokers, Asians and women -- did better on Iressa.
Dr. Masahiro Fukuoka of Kinki University in Osaka, Japan and Dr. Tony Mok of the Chinese University of Hong Kong and colleagues tested tissue samples from 683 patients with non-small-cell lung cancer, the most common type.
Iressa and Tarceva, known generically as erlotinib and made by Genentech, now owned by Roche AG (ROG.VX), are monoclonal antibodies -- genetically engineered immune system molecules that target a molecule called epidermal growth factor receptor or EGFR. Tumors use EGFR to grow themselves blood supplies.
Such targeted therapies have far fewer side effects than standard chemotherapy and because they are pills and are convenient to take.
"Those drugs, while commercially available and widely used, are only modestly effective if you just give them to any old patient," Dr. Richard Schilsky, president of the American Society of Clinical Oncology and blood cancer specialist at the University of Chicago, said in an interview.
HIGH RESPONSE
Mok's and Fukuoka's study showed Iressa worked in 71 percent of patients who had the EGFR mutation, versus 43 percent of those who did not have it.
"All patients with lung cancer need to have their tumors tested for EGFR," Schilsky said. "Those who have abnormalities (in EGFR) are best treated with drugs like Iressa or Tarceva." Those who do not have the mutations will benefit best from standard chemotherapy, he said.
The study was done in non-smokers, but would likely apply to smokers who have EGFR mutations, Schilsky said -- adding that most do not.
Iressa may make a comeback in the United States if coupled with an EGFR test, Schilsky said.
More details of the study will be released at ASCO's annual meeting later this month but a summary of the findings, called an abstract, was released ahead of the meeting on Thursday.
Last month the European Medicines Agency recommended approval of Iressa, a recommendation usually followed by the European Commission.
Roche has said it will start a new trial for Tarceva in lung cancer patients with EGFR mutations.
Lung cancer kills 1.2 million people a year and is the top cause of cancer death globally. Many drugs are used to treat it but almost always stop working eventually, in part because most patients are not diagnosed until tumors have spread.
Chemotherapy, infused over a period of several hours, targets rapidly growing cells and thus often has severe side effects such as nausea, diarrhea and hair loss.
Companies such as Genzyme Corp. (GENZ.O) now market tests that show whether cancer patients have the EGFR mutation.
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