PHP84 Lung Cancer Treatment: A Paradigm Shift to Targeted Therapies in Clinical Trial Settings in Asia

Abstract

Lung cancer (LC), the most common cancer in Asia, accounts for nearly 14.3% of all new cancer incidences and 18.5% of all cancer-related deaths. Limited treatment options are available in the advanced stages of LC indicating a high unmet need. The objective of this study was to conduct an assessment of drugs in development (both off-patent and pipeline) for LC treatment in Asia. Clinicaltrials.gov was searched in February 2012 for randomized controlled trials (Phase II, III, and IV) investigating pharmacologic interventions for LC in Asia. In total, 137 clinical trials (planned, ongoing, and completed trials) were identified. Of these, approximately 42% trials have sites only in Asia; China and/or Taiwan being the major investigational sites. Among these trials, 44 drugs were found to be in pipeline for the treatment of LC. Major progress was observed in the area of molecular targeted therapies either as monotherapy or in combination with chemotherapy (50%) followed by chemotherapeutic agents (25%) and immunotherapeutic agents (25%). Majority (59%) of the ongoing phase III trials are assessing targeted therapies. The key therapeutic classes in assessment include epidermal growth factor receptor (EGFR)-targeting agents, vascular endothelial growth factor receptor (VEGFR)-targeting agents, protein kinase inhibitors, hepatocyte growth factor receptor (HGFR) or c-Met inhibitors, and pan-ErbB inhibitors. Among trials evaluating targeted therapies, EGFR-targeting agents were being investigated in more than 50% of the trials followed by VEGFR-targeting agents. The research focus for the treatment of LC is shifting from chemotherapies towards the targeted therapies in Asia. Among the targeted therapies, the major focus is on the EGFR-targeting agents.