By Amy D’Orazio, PhD

Tarceva^® (erlotinib), a novel targeted agent, shows activity in lung cancer. Bronchoalveolar carcinoma (BAC), a rare type of lung cancer, is on the rise. Unlike other subtypes of lung cancer, BAC is more common in nonsmokers than smokers. Tarceva is a novel agent that, like Iressa^TM (gefitinib), targets epidermal growth factor receptor (EGFR). Data delivered at ASCO showed that Tarceva had promise in patients with BAC with 27% of 30 patients having disease shrinkage.

Taxol^®; (paclitaxel)/Gemzar^® (gemcitabine) study is promising for metastatic breast cancer (MBC). Adding Gemzar to Taxol yielded a 27% decrease in the probability of disease regression for women with MBC in a phase III trial comparing the combination to Taxol alone. More than 500 women with MBC were studied with the results showing that adding Gemzar prolonged the time to progression, although the risk of developing low white blood cell counts increased with the combination therapy.

SU11248 picks up where Gleevec^TM (imatinib mesylate) leaves off. Patients with gastrointestinal stromal tumors (GIST) were greatly encouraged last year with the report of a new drug called Gleevec, an inhibitor of cell growth that targets proteins that cause cancer cells to run amok. However, cancer cells can become resistant to Gleevec and that’s where SU11248 comes in. The new drug switches off four of the proteins incorrectly activated in tumor cells, including the ones inhibited by Gleevec. Of 45 patients with Gleevec-resistant metastatic GIST tumors, about half showed tumor shrinkage or stabilization.

Aloxi^TM (palonosetron) controls chemotherapy-induced nausea/vomiting (CINV). Pooled results from two large phase III studies of a new agent, Aloxi, showed it was better able to control nausea and vomiting than other similar agents. In these studies, almost 12% fewer patients of the more than 1,100 women in the study experienced nausea/vomiting within the first 24 hours of chemotherapy, and 17% fewer experienced delayed CINV (occurring more than 24 hours after treatment) with Aloxi, which is currently under review by the FDA with a decision expected this month.

Chemotherapy effective for older breast cancer patients. Although older breast cancer patients are more likely to have disease that has spread to the lymph nodes, they are less likely to receive aggressive chemotherapy treatment because of the perception that they are too frail. In this study of almost 6,500 patients, it was found that a healthy elderly woman tolerated, and was as likely to benefit from, adjuvant chemotherapy as younger patients.

Erbitux^TM (cetuximab or C225), another new hope for colorectal cancer patients. In addition to the exciting results with Avastin^TM (bevacizumab) (see page 70), an antibody known as Erbitux, which targets EGFR, increases the effectiveness of chemotherapy with more than twice the number of colorectal cancer patients studied experiencing tumor shrinkage with Erbitux plus chemotherapy compared to chemotherapy alone. The median time to relapse was prolonged by almost three months.

Telcyta^TM (TLK286) effective for relapsed ovarian cancer. Treatment of ovarian cancer patients whose disease is unresponsive to Taxol and platinum agents remains challenging. A new agent known as Telcyta has shown activity in these patients in a phase II trial with weekly Telcyta. Severe side effects were rare, most likely due to the design of this drug, which is preferentially activated within tumor cells and does not appear to affect normal cells to any large extent.

New effective monoclonal antibody therapy for lymphoma. IDEC-114 is a novel antibody targeted to a protein on the surface of most lymphomas known as CD80. Data from 25 advanced lymphoma patients who relapsed after chemotherapy showed this antibody was effective, with 19% of patients showing complete disease regression after four infusions of IDEC-114 given once a week. No severe side effects were seen.