Bringing Online a Second-Line Therapy

Esophageal cancer responds to gefitinib as second line treatment

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) After the initial therapy for esophageal cancer fails, patients don’t have many choices. A recent study finds that a second-line therapy could be coming online.

A drug that’s used to treat non-small cell lung cancer (NSLC) – Iressa (gefitinib) – may be useful as a second-line therapy for cancer of the esophagus.

"Ask about second-line cancer therapies."

A British study called COG (Cancer Oesophagus Gefitinib) involved 450 patients with esophageal cancer that had progressed (gotten worse) after treatment of up to two chemotherapy regimens.

Iressa is an anti-cancer medication that attacks what’s called the epidermal growth factor receptor (EGFR), a protein that helps cancer cells to multiply. The medication is currently used to treat NSLC that is no longer responding to therapy in Europe.

Manufactured by AstraZeneca, Iressa is not currently available in the U.S. 

Patients in this new study were given either a placebo or Iressa.

The median time before the disease got worse – progression-free survival (PFS) was 35 days for people who took a placebo compared to 49 days for those who received Iressa.

The medication also improved quality of life for these patients by helping with the difficult and painful swallowing esophageal cancer patients often experience.

According to the researchers, some patients also had lasting benefits from the treatment.

Additional study is planned that will look at the biopsies (tissue samples removed from the tumor) of 300 patients. The goal of this study will be to identify the molecules that can predict patients who could benefit from this therapy.

"If such a benefit can be identified, then given the good tolerance of gefitinib it could potentially be used in relapsed esophageal cancer," Prof Ferry said.

Commenting on this study, Prof Jean-Yves Douillard, chair of the ESMO Educational Committee, said “Hopefully a biomarker predicting efficacy will be identified to allow the use of gefitinib in esogastric cancer in a personalized fashion. Considering the present practice however, future studies should have a more active treatment choice than placebo in the control arm,” said Prof Douillard, who was not involved in this study.

These research findings were presented at the ESMO 2012 Congress of the European Society for Medical Oncology in Vienna.

Reviewed by: 
Review Date: 
October 2, 2012
Last Updated:
October 2, 2012