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Cancer Summaries & Commentaries Vol. 1, No. 2
Broadening the Horizon of Targeted Agents in Advanced Non–Small-Cell Lung Cancer

Release Date: August 26, 2008
Expiration Date: August 26, 2009

Publication Overview

Author

PER Editorial Staff

Overview and Purpose

The current standard of care in first-line therapy for metastatic nonsquamous non–small-cell lung cancer (NSCLC) is a taxane-based platinum doublet regimen combined with an anti–vascular endothelial growth factor (VEGF) monoclonal antibody (MoAb). However, many patients are excluded from receiving this treatment due to safety concerns related to brain metastases or squamous cell histology. Additionally, not all patients respond, and additional treatment options are needed. Recent analyses of patients with NSCLC and brain metastases receiving anti-VEGF antibodies have demonstrated an acceptable safety profile. Efforts to increase the therapeutic ratio of first-line therapy include moretolerable cytotoxic backbones, such as antifolates and proapoptotic agents. Antibodies to insulin-like growth factor-1 receptor (IGF-1R) have also been combined with first-line platinum doublets and have yielded high response rates in patients with squamous histology. Additional treatment options are needed for patients with metastatic NSCLC who progress after first- or second-line therapy. Novel inhibitors of epidermal growth factor receptor (EGFR) that in preclinical studies have demonstrated activity against tumor cells with resistance mutations in the EGFR gene are being investigated.

The purpose of this activity is to update physicians on the latest developments in targeted agents for metastatic NSCLC.

Target Audience

This publication is intended for medical oncologists involved in the care of patients with lung cancer. No specific skills or knowledge other than a basic training in oncology is required for successful participation in this activity.

Learning Objectives

Upon completion of this educational activity, you should be able to:

  • Discuss safety data on an anti-VEGF MoAb in patients with central nervous system metastases resulting from advanced NSCLC
  • Evaluate the efficacy and safety of the combination of a MoAb targeting VEGF with antifolate/platinum-based chemotherapy as first-line therapy for advanced nonsquamous NSCLC
  • Evaluate the efficacy and adverse event profile of combining an anti–IGF-1R MoAb with first-line chemotherapy in advanced NSCLC
  • Describe the feasibility of a recombinant death receptor ligand combined with standard chemotherapy and an anti-VEGF antibody in the first-line treatment of advanced NSCLC
  • Evaluate the safety and efficacy of a novel EGFR tyrosine kinase inhibitor (TKI) in patients with advanced NSCLC and acquired resistance to first-generation EGFR-specific TKIs

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  • CME credit will be granted for only 1 form of participation, either online or via the printed publication.

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Nasser Hanna, MD
Research Funding – Bayer Pharmaceuticals Corporation, Bristol-Myers Squibb Company, Eli Lilly and Company, Genentech, Inc.
Speaker’s Bureau – Eli Lilly and Company

PER Editorial Staff
No relevant relationships to disclose

This CME activity might include discussion of investigational and/or unlabeled uses of drugs. If the activity includes discussion of investigational and/or unlabeled uses of a drug, specific information is located on the title page. Please refer to the full prescribing information for each drug discussed in this newsletter for FDA–approved dosing, indications, and warnings.

Commercial Support
An educational grant for this activity was provided by Genentech BioOncology.

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Illustration

Tumor progression involves a large number of growth factors, such as epidermal growth factor (EGF) and insulin-like growth factors (IGFs) as well as proangiogenic factors, including vascular endothelial growth factor (VEGF), placental growth factor (PlGF), platelet-derived growth factor (PDGF), and basic fibroblast growth factor (bFGF). These factors originate from a variety of sources, including organs and endothelial cells, and can also be released from the extracellular matrix (ECM) through the action of myeloid cell–derived matrix metalloproteinases (MMPs). Several of these mitogenic and angiogenic factors are also produced by the tumor itself. These ligands and their receptors are therefore an active area of research for anticancer therapies.

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The views and opinions expressed in this activity are those of the authors and do not necessarily reflect the views of the sponsor, supporter, or publisher. Although great care has been taken in compiling and checking the information given in this activity to ensure accuracy, the authors, and Physicians' Education Resource and its servants or agents shall not be responsible or in any way liable for the continued currency of the information or for any errors, omissions, or inaccuracies in this activity, whether arising from negligence or otherwise howsoever or for any consequences arising therefrom.

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Editor, Cancer Summaries & Commentaries
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