Tarceva for squamous stage IV - 1256751

laurielu
Posts:9

Good morning, I am checking on the possibility of getting put on Tarceva. My second opinion onc. Put me on erbitux but before my insurance would approve it they said my biopsy material had to be tested to be sure I was a candidate for erbitux. I was told later that meant I had to have the EGFR mutation in order for erbitux to work. My insurance approved so I have been thinking I am EGFR positive (I am following up with my onc's office on Tuesday).
Question: I am on my 3rd line of chemo, if it is true that I have the EGFR mutation with squamous is Tarceva going to be an option for me?

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Reply # - May 26, 2013, 10:36 AM

catdander
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Hello Laurielu, I'm very sorry you're in this situation but I'm sure we'll be able to help you understand your options.
It's really good that tarceva has shown to have efficacy on your cancer. It doesn't necessarily mean you have the EGFR mutation though. I wonder where you are. Many parts of the world now approve tarceva for second or later lines of nsclc without or with the mutation.
Here is a blog post on the subject. http://cancergrace.org/lung/2010/09/21/benefit-from-egfr-tki-if-egfr-wt/

I hope you are given the chance to use it again. It's certainly worth going a step above the person who made the decision to stop paying for tarceva. Your doctor may be able to help you there also.

let us know what happens
Janine
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Reply # - May 26, 2013, 06:40 PM

Dr West
Posts: 4735

Janine's exactly right. The approval for Erbitux (cetuximab) was presumably based on being positive for the EGFR protein by a test called immunohistochemistry (IHC), which is considerably more common (about 80% of patients with NSCLC) than an EGFR mutation (about 10 of patients with advanced NSCLC in North America, and 25-30% of patients in Europe). Tarceva (erlotinib) has some evidence of typically relatively modest activity in patients who don't have an EGFR mutation, and it is typically extremely active in patients with an EGFR mutation. Unfortunately, EGFR mutations are very uncommon in squamous NSCLC tumors.

-Dr. West

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