Drug Fails to Prolong Cancer Patient Lives

Lung cancer patients do not live longer with sorafenib

(RxWiki News) A drug often used to treat kidney and liver cancer may also fight a type of lung cancer. New research, though, shows that it does not extend the lives of lung cancer patients.

Sorafenib (marketed as Nexavar by Bayer) is a drug known as a multikinase inhibitor. These types of drugs block the actions of kinases, which are enzymes that can promote tumor growth.

Taken in tablet form, the medication has a proven track record for preventing tumor growth in patients with advanced kidney cancer and a type of liver cancer that cannot be removed with surgery.

"Explore multiple options when it comes to lung cancer therapy."

A new study shows that sorafenib may also inhibit the spread of lung cancer, but does not help patients live longer.

Dr. Luis Paz-Ares, MD, head of the Oncology Service Hospital at Virgen del Rocio University Hospital in Seville, Spain, presented the findings at the 2012 Congress of the European Society for Medical Oncology in Vienna.

For the study, 703 patients with advanced non-small cell lung cancer (NSCLC), were either given 400 milligrams of sorafenib twice daily or a placebo.

Survival was about the same in each group with a median overall survival of 243 days for the sorafenib patients and 253 days for the placebo group.

"Treatment with sorafenib does not result in improved survival as compared to placebo as a third or fourth line treatment in advanced non-small cell lung cancer," Dr. Paz-Ares said. Third- and fourth-line treatments are given after treatments fail and are applied as cancer progresses.

While patients taking sorafenib were not living longer than those in the placebo group, Dr. Paz-Ares did note “relevant anti-tumor activity of the drug.” Study results suggested that patients with EGFR-mutant tumors may benefit.

EGFR is an enzyme meaning epidermal growth factor receptor. Excessive levels of the EGFR are often observed in cancer cells.

Researchers conducted tumor analysis on 347 patients and found that 26 percent had EGFR tumors. Median overall survival was two times longer in patients with EGFR mutations receiving sorafenib versus placebo.

Dr. Paz-Ares’s team also looked at the difference in overall survival between patients with wild type EGFR receiving sorafenib or placebo. In a wild type EGFR, there is no mutation detected within the EGFR gene.

The significant benefit of sorafenib in the subgroup of patients with EGFR-mutant tumors is a great breakthrough that merits validation in a prospective study, according to the scientists. EGFR status may help select patients who will benefit most from the drug.

Investigators suggest that using sorafenib in earlier stages of cancer may benefit patients who have been improving using specific EGFR tyrosine kinase inhibitors.

The fact that there is no significant impact of sorafenib on overall survival highlights the increasing importance of post-study therapies in lung cancer trials, said study authors.

The study was presented in September at the European Society for Medical Oncology's ESMO2012 Congress in Vienna.

Research is considered preliminary before it’s published in a peer-reviewed journal.

Review Date: 
October 8, 2012