njliu
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Found this article interesting. My interpretation is while the current standard treatment of WBR yields 6 month survival, concurrent Tarceva + WBR on EGFR wild type yields 12 months and on EGFR mutants 19 months. Wow! This is 2 and 3 times respectively of current standard. If this is correct, there needs to be significant change in current practice where generally Radiation Therapists prefer to stop Tarceva during WBR. Appreciate any validation from GRACE doctors. Thank you.
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Reply # - September 7, 2013, 10:08 AM
Reply To: Concurrent Tarceva and WBR to treat Brain Mets in
No, in my mind this is provocative but certainly not convincing to give an EGFR inhibitor with WBR. As the authors note, this is a small, single arm study, and comparisons to historical expectations are known for being staggeringly inaccurate in predicting what a randomized trial will show.
The Radiation Therapy Oncology Group has done a randomized trial in which Tarceva (erlotinib) was given to some patients getting WBR, while other arms got some other medications or nothing -- to my knowledge we're still awaiting the results of that trial. If it was completed and reported, I'm not aware of the results, which means it's nearly certain that it didn't show a significant benefit from addition of Tarceva to WBR. Either way, at this time, I can say that this question is being evaluated or has been studied in a larger setting of a proper randomized clinical trial, but that for now, concurrent administration is feasible but not clearly superior.
-Dr. West