Biological therapy for lung cancer
Types of biological therapy
Biological therapies are treatments that can control or stop the growth of cancer cells. Some types of biological therapy can treat advanced non small cell lung cancer. They include erlotinib (Tarceva), gefitinib (Iressa) and crizotinib (Xalkori).
Doctors are using clinical trials to test other types of biological therapy such as cetuximab (Erbitux), bevacizumab (Avastin) and some very new drugs. Research is also looking at using some biological therapies to treat earlier stages of lung cancer.
Doctors are using clinical trials to test other types of biological therapy such as cetuximab (Erbitux), bevacizumab (Avastin) and some very new drugs. Research is also looking at using some biological therapies to treat earlier stages of lung cancer.
Erlotinib
is also known by its brand name, Tarceva (tar-see-vah). You take it as a
tablet. Erlotinib works by blocking particular proteins called
epidermal growth factor receptors (EGFR) in the cancer cells. Cancers
that have EGF receptors are called EGFR positive. Between 10 and 15
people out of every 100 with non small cell lung cancer (10 to 15%) have
EGFR positive cancer. Doctors check your cancer cells to see if they
have EGF receptors before you have this treatment.
You may have erlotinib if you have locally advanced or metastatic non small cell lung cancer which is EGFR positive
Some trials are combining erlotinib with chemotherapy or other biological therapy drugs. You can find out more about research into erlotinib for lung cancer on our lung cancer research page.
You may have erlotinib if you have locally advanced or metastatic non small cell lung cancer which is EGFR positive
- As a first line treatment (that is, if you have not had drug treatment before)
- Or if your cancer has continued to grow despite having chemotherapy (NICE do not recommend it if you have had two or more chemotherapy regimens which did not work and included docetaxel)
Some trials are combining erlotinib with chemotherapy or other biological therapy drugs. You can find out more about research into erlotinib for lung cancer on our lung cancer research page.
Gefitinib has the brand name Iressa. It also works by blocking epidermal growth factor receptors. The National Institute for Health and Clinical Excellence (NICE)
has recommended it as a first treatment for non small cell lung cancer
that is locally advanced or has spread. To have gefitinib, the cancer
cells must have EGFR receptors.
In December 2010, after reassessing gefitinib the Scottish Medicines Consortium (SMC) decided not to recommend gefitinib for use within the NHS in Scotland. They say it is not cost effective.
A recent meta analysis of trials comparing gefitinib with chemotherapy as a first treatment for people with advanced cancer found that there was no difference in how long people lived. But there was a difference in the side effects. People who had gefitinib had less tiredness, sickness and effects on the blood cells. They did have more skin problems (rashes), diarrhoea, and irritation of the lung. They also had a higher quality of life compared to people having chemotherapy.
In December 2010, after reassessing gefitinib the Scottish Medicines Consortium (SMC) decided not to recommend gefitinib for use within the NHS in Scotland. They say it is not cost effective.
A recent meta analysis of trials comparing gefitinib with chemotherapy as a first treatment for people with advanced cancer found that there was no difference in how long people lived. But there was a difference in the side effects. People who had gefitinib had less tiredness, sickness and effects on the blood cells. They did have more skin problems (rashes), diarrhoea, and irritation of the lung. They also had a higher quality of life compared to people having chemotherapy.
Crizotinib
has the brand name Xalkori. It can help to control advanced NSCLC in
people whose cancer cells have an overactive version of a protein called
anaplastic lymphoma kinase (ALK). It is licensed in the UK for people
who have already had other treatments for NSCLC. The National Institute for Health and Clinical Excellence (NICE) are currently assessing this treatment.
Crizotinib can stop the cancer cells growing for a time but it only works in cancers with the overactive protein. So it is not suitable for everyone. About 1 in 20 people (5%) with non small cell lung cancer (NSCLC) have the overactive ALK protein.
Crizotinib can stop the cancer cells growing for a time but it only works in cancers with the overactive protein. So it is not suitable for everyone. About 1 in 20 people (5%) with non small cell lung cancer (NSCLC) have the overactive ALK protein.
Other types of biological therapy being used in trials for lung cancer include
A recently published American study found that adding bevacizumab to carboplatin and paclitaxel chemotherapy didn't work any better than the chemotherapy alone. This study was looking at people who were over the age of 65 years with stage 3B or stage 4 non small cell lung cancer.
Cetuximab (Erbitux)
Cetuximab is a monoclonal antibody which blocks growth factor receptors on cells. It has been used, with chemotherapy, in trials for advanced non small cell lung cancer. The results so far have been quite encouraging in terms of helping people to live longer. Research is continuing to try to find the best way of using cetuximab.Bevacizumab (Avastin)
Bevacizumab (also called Avastin) is a monoclonal antibody (MAB) that stops cancer cells making the blood vessels they need so that they can grow. In August 2007, bevacizumab was licensed in Europe to treat advanced non small cell lung cancer in combination with platinum based chemotherapy, such as cisplatin or carboplatin. This treatment has not been approved by the National Institute for Health and Clinical Excellence (NICE) and so is not used as a standard treatment on the NHS in the UK.A recently published American study found that adding bevacizumab to carboplatin and paclitaxel chemotherapy didn't work any better than the chemotherapy alone. This study was looking at people who were over the age of 65 years with stage 3B or stage 4 non small cell lung cancer.
New biological therapy drugs
Clinical trials for lung cancer are looking at many new biological therapy drugs. You can find out about them on the lung cancer research page. Or go to our clinical trials database. Go to the advanced search and choose 'lung cancer' from the dropdown menu of cancer types and 'biological therapy' from the list of treatment types. If you want to see all the trials, tick the boxes for closed trials and trial results.
The side effects vary depending on which drug you have. But
the possible side effects of biological therapies for lung cancer
include
- Tiredness (fatigue)
- Diarrhoea
- Skin changes such as rashes or discolouration – rashes may be severe for some people
- A sore mouth
- Weakness
- Loss of appetite
- Low blood counts
- Swelling of parts of the body, due to build up of fluid
Our lung cancer organisations page gives details of people who can give information about lung cancer biological therapies. Some organisations can put you in touch with a cancer support group. Our lung cancer reading list has information about books and leaflets on lung cancer treatments.
If you want to find people to share experiences with online, you could use CancerChat, our online forum. Or you can go through My Wavelength. This is a free service that aims to put people with similar medical conditions in touch with each other.
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