This is a relatively a new approach to cancer treatment that target specific biological processes often essential to tumour growth. Biological therapy can include monoclonal antibodies, vaccines and gene therapies. As biological therapies target cancer-specific processes, they may potentially be more effective than other types of treatment (such as chemotherapy and radiotherapy) and less toxic to non-cancerous, healthy cells.
In the form of lung cancer medications, several types of biological therapy exist for the treatment of advanced non-small cell lung cancer. These are either given as monotherapy or in conjunction with other therapies at various stages of advanced disease.
Description: In today's era the lung cancer treatment, be it small cell lung cancer or be it non-small cell lung cancer treatment, the existence of two oral anticancer treatments are given as: Erlotinib (Tarceva) and Gefitinib (Iressa). Both are EGFR-TKI that block the signal pathways involved in cell proliferation.
Erlotinib:
Erlotinib is available as film coated tablets 25mg, 100mg or 150mg. The recommended daily dose of erlotinib 150mg taken at least one hour after food. Erlotinib is licensed for the treatment of NSCLC and metastatic pancreatic cancer. In the setting of NSCLC, erlotinib is licensed for use with three patient populations. In the first-line setting erlotinib 150mg is licensed for the treatment of patients with locally advanced or metastatic NSCLC with EGFR activating mutations. The SPC26 stipulates that prior to initiation of erlotinib therapy, people with chemotherapy NSCLC should undergo EGFR mutation testing using a well validated and robust methodology.
In the post-first-line maintenance setting, erlotinib is licensed as a monotherapy for people with locally advanced or metastatic Non Small Cell Lung Cancer whose disease is stable following four cycles of standard platinum-based first-line chemotherapy.
In the second-line setting, erlotinib is licensed for patients with locally advanced or metastatic NSCLC following failure of at least one prior chemotherapy.
Gefitinib:
Gefitinib is available as a 250mg film-coated tablet. Take the dose of gefitinib as one 250mg tablet daily. This medication is licensed for the treatment of adult patients with locally advanced or metastatic NSCLC with EGFR activating mutations. The licence places no restriction on where in the treatment pathway gefitinib is used. As was noted for erlotinib, the SPC27 for gefitinib stipulates that a well-validated and robust methodology is used to determine EGFR mutation status before therapy.
- Some warnings and precautions are as: Increased incidents of interstitial lung disease have been observed in epidemiological studies of Gefitinib 250mg.
- Periodic liver function testing is also recommended for patients treated with gefitinib.
In 2003 the Food and Drug Administration (FDA) in the USA approved the use of Gefitinib 250mg as a second-line treatment for patients who are refractory to platinum-based chemotherapy or docetaxel.
The approval was made under the FDA’s accelerated approval regulations that allow the conditional approval of medicines based on surrogate outcomes, in this case tumour response rate.
Cost: Both the medications Erlotinib and Gefitinib are available at the discounted price.
