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Targeting the HER1/EGFR receptor to improve outcomes in non-small-cell lung cancer.

Non-small-cell lung cancer represents a growing global burden and remains a therapeutic challenge. Only small improvements in survival have been made with standard chemotherapeutic approaches to advanced disease in recent history. Novel biologic targeted therapies offer the potential of improving patient management and treatment outcomes in non-small-cell lung cancer. Prominent among these novel agents are the HER1/epithelial growth factor receptor (EGFR) inhibitors. One of these agents, gefitinib (Iressa), is already approved for use in advanced, refractory non-small-cell lung cancer. Erlotinib (Tarceva) is a promising HER1/EGFR inhibitor in phase III evaluation as first-line therapy combined with chemotherapy and as second-/third-line monotherapy in advanced non-small-cell lung cancer. In addition, erlotinib is being evaluated in combination with the angiogenesis inhibitor bevacizumab (Avastin), a strategy combining two new modalities in cancer treatment. Results of these trials will provide important information on optimal use of these new targeted therapies and may offer the promise of improving the treatment of non-small-cell lung cancer.