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FDA approves Gilotrif (afatanib) for treatment in late stage lung cancer

Often times, our patients ask us if we, as hematologist/oncologists in Tarzana and West Hills communities,  keep on top of the latest treatments and trends in regards to cancer care. In 2013, our relationships with the American Society of Clinical of Oncology, American Society of Hematology,  Medical Oncology Association of Southern California help us stay on top of these treatments and trends on a DAILY basis. It is also enjoyable to discuss these treatments in a team approach with my colleagues, Dr Omid Shaye and Dr. Ashkan Lashkari with their experiences treating other patients. I wanted to share with you a recent development in regards to lung cancer.

More recently, major advances are being made in the treatment of lung cancer. These advances really encapsulate the "personalized medicine" that has been a thrust of cancer care in the last several years. "Personalized Medicine" in this regards generally regards the genetic profile of a lung tumor, and the possibility of treatment with a pill to target the genetic mutation which may be driving the tumor's growth. These pills are generally not considered chemotherapy in the traditional sense with the anticipated side effects. It also marks the changes that we, as medical oncologists think about lung cancer. Instead of thinking of lung cancer as one disease, it is recognized as a constellation of genetic mutations, for which targeted therapies may prove useful. 

Afatanib, also known by its trade name Gilotrif was approved this summer for the treatment of patients with lung cancer, whose tumor expresses specific EGFR mutations. Mutations in the epidermal growth factor receptor (EGFR) are in part responsible in up to 10% of lung cancers. Lung Cancers with EGFR mutations have been shown to respond to medications targeting this defect better than traditional chemotherapy. Afatanib is the second generation of these medications (called tyrosine kinase inhibitors or TKIs) and has been shown to be effective in lung cancers which have specific mutations, which can be detected by an FDA approved test. 

More recently, afatanib was also compared to a recent standard combination of chemotherapy of cisplatin and pemetrexed and published in September, showing that afatanib is efficacious in a front line setting. The results of this study (LUX-Lung 3 trial) in combination with prior studies were so convincing that Dr Cory Langer, a lung cancer expert, wrote in the accompanying editorial that further studies comparing TKI's versus traditional chemotherapy in patients with EGFR-mutated lung cancer should probably be stopped.

This is further proof of the slow but steady improvements the medical community are making in the fight against lung cancer. 

Drs Omid Shaye, Ashkan Lashkari and I do our best in staying up to date in  the latest developments in lung cancer.
 Please return to our blog for more updates during this month on lung cancer developments.

Call us at 818 346 1773 for an appointment. 


Dr. Christopher Ho

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