Erlotinib Plus Cisplatin-Based Chemoradiation May Prolong Survival of Patients With Locally Advanced Cervical Cancer
A new clinical study has found that erlotinib (Tarceva) has promising potential to improve treatment for cervical cancer. Published in Cancer, the findings by Nogueira-Rodrigues et al indicate that larger trials are warranted to determine whether the drug should become part of standard therapy for women with the disease.
Nearly half a million new cases of cervical cancer are reported worldwide each year, making it the third most common cancer among women. Despite the widespread use of screening programs and the recent advent of vaccines against human papillomavirus, cervical cancer continues to be a significant public health problem.
Cisplatin-based chemoradiation is the standard therapy for locally advanced cervical cancer. Unfortunately, treatment responses are unpredictable and often disappointingly brief. A potentially promising new treatment strategy involves targeting the epithelial growth factor receptor (EGFR), which is frequently overexpressed in cervical cancer. Inhibiting this receptor is known to have antitumor effects against a variety of cancers.
Study Details
The current phase II trial was designed to test the potential of the EGFR inhibitor erlotinib in combination with with chemoradiation therapy in 36 women with cervical cancer. Patients had stage IIB to IIIB epidermoid cervical cancer, no prior therapy, and an Eastern Cooperative Oncology Group performance status of 0 to 2. Patients were treated with erlotinib 150 mg/d 1 week before and in combination with cisplatin and radiotherapy, followed by brachytherapy. Median duration of therapy was 77 days, and median follow-up time was 59.3 months.
The therapy was well tolerated overall, and 34 patients (94.4%) achieved a complete response. After 2 years, 91.7% of women were alive, and 80.6% experienced no progression of their disease. After 3 years, 80% of women were alive, and 73.8% experienced no disease progression.
“While cervical cancer is a neglected disease and very few clinical trials have been reported in the last 10 years, some groups, including ours, have reported that its biology might be prone to targeted therapy,” said Angelica Nogueira-Rodrigues, MD, PhD, of Instituto Nacional de Cancer. “To the best of our knowledge, this is the first study to present that a targeted agent has promising activity in the management of locally advanced cervical disease.” She added that targeted therapies may be added to the standard treatment for locally advanced cervical cancer if randomized trials confirm the current study’s results.
Dr. Nogueira-Rodrigues is the corresponding author for the Cancer article.
The study was supported by the Brazilian National Cancer Insitute and Fundacao do Cancer. Erlotinib was supplied by Roche Pharmaceuticals. The study authors reported no potential conflicts of interest.
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