According to the results of a Phase III clinical trial presented at the 2009 annual meeting of the American Society of Clinical Oncology (ASCO), addition of the investigational targeted therapy Zactima™ (vandetanib) to chemotherapy with Taxotere® (docetaxel) delayed cancer progression among patients with previously treated, advanced non–small cell lung cancer.
Lung cancer is the leading cause of cancer death among both men and women in the United States. Because treatment outcomes for patients with advanced disease remain poor, researchers continue to explore new approaches to treatment.
Targeted therapies are anticancer drugs that interfere with specific pathways involved in cancer cell growth or survival. Some targeted therapies block growth signals from reaching cancer cells; others reduce the blood supply to cancer cells; and still others stimulate the immune system to recognize and attack the cancer cell. Depending on the specific “target,” targeted therapies may slow cancer cell growth or increase cancer cell death. Targeted therapies may be used in combination with other cancer treatments such as conventional chemotherapy.
Zactima is an oral medication that targets both the epidermal growth factor receptor (EGFR) and the vascular endothelial growth factor receptor (VEGFR). Both of these receptors are known to play a role in NSCLC. VEGFR influences tumor blood supply, and EGFR contributes to cancer cell proliferation and survival.
To evaluate Zactima in combination with chemotherapy for the treatment of advanced (Stage IIIB or IV) NSCLC, researchers conducted a Phase III clinical trial. The study enrolled 1,391 patients who had previously been treated with chemotherapy.
Study participants were assigned to one of two treatment groups:
- Chemotherapy with Taxotere plus placebo
- Chemotherapy with Taxotere plus Zactima
Patients have now been followed for roughly one year.
- Survival without cancer progression was 17.3 weeks among patients treated with chemotherapy plus Zactima compared with 14 weeks among patients treated with chemotherapy alone. Overall survival did not differ significantly between the two study groups.
- Patients treated with Zactima experienced an improvement in cancer symptoms.
- Side effects that were more common among patients treated with Zactima included diarrhea, rash, and low white blood cell counts.
These results suggest that the addition of Zactima to second-line chemotherapy for NSCLC may delay cancer progression and reduce cancer symptoms.
Reference: Herbst RS, Sun Y, Korfee S et al. Vandetanib plus docetaxel versus docetaxel as 2nd-line treatment for patients with advanced non-small-cell lung cancer (NSCLC): a randomized double-blind phase III trial (ZODIAC). Presented at the 2009 annual meeting of the American Society of Clinical Oncology, May 29-June 2, 2009, Orlando, FL. Abstract CRA8003.
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