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Ovarian Cancer: Erlotinib Biological Maintenance Therapy

by Steven Vasilev, M.D.
for About.com

Updated March 23, 2008

About.com Health's Disease and Condition content is reviewed by the Medical Review Board

Maintenance Therapy

It is not clear if adding treatment of any kind to the standard first six treatments with chemotherapy for advanced ovarian cancer can improve your chances for a cure. Various chemotherapy drugs and some “biological” agents have been studied and continue to be studied. The question is the subject of some very exciting research.

Erlotinib or Tarceva

Erlotinib is a “biological” agent used to treat certain types of lung cancer and has been used in combination with gemcitabine chemotherapy to treat pancreatic cancer. It is a type of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, and is also called erlotinib hydrochloride, CP-358,774, OSI-774, and Tarceva. These are technical terms that you can research further, but the most important information is in the next few paragraphs.

EGFR is produced or “over-expressed” by the cells of many cancers, including ovarian. When present in large amounts on cancer cells it often means the cancer is more aggressive and spreads or metastasizes readily. EGFR also protects cancer cells from chemotherapy effect.

Basically erlotonib stops the growth of tumor cells by blocking an important enzyme needed for cancer cell growth. The technical description is inhibition of EGF receptor tyrosine kinase (the enzyme) activity. This tyrosine kinase activating receptor is a protein which is present in large quantities or not based on activity of the EGFR gene. This represents a very cutting edge targeted “biological” approach to cancer treatment.

Phase III Clinical Trial

As of March 2008 a randomized phase III trial is studying erlotinib to see how well it works compared to observation in treating patients who have completed first-line chemotherapy for ovarian cancer, peritoneal cancer, or fallopian tube cancer. There are other trials looking at additional maintenance therapy strategies, but this is one which uses a targeted “biological” agent rather than a chemotherapy drug.
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