A trial comparing erlotinib with docetaxel for non small cell lung cancer that has got worse despite chemotherapy (EMPHASIS-lung)

Cancer type:

Lung cancer

Non small cell lung cancer

Status:

Results

Phase:

Phase 3

This trial compared erlotinib and docetaxel for a type of non small cell lung cancer called squamous cell cancer. It was for people whose cancer had got worse despite having treatment with a platinum chemotherapy drug.

More about this trial

Doctors sometimes use chemotherapy for non small cell lung cancer (NSCLC) that has spread outside the lung or to another part of the body. They often use a platinum chemotherapy drug such as cisplatin or carboplatin.

Sometimes the cancer starts growing again. In this situation, doctors might use either docetaxel (Taxotere) or erlotinib (Tarceva). But they are not sure which is best to use.

As well as comparing these 2 drugs, this trial also looked at a test called VeriStrat. This looks for certain proteins in blood samples. Everybody taking part in this trial had the test before they started treatment.

Depending on the proteins in their blood, people were classed as VeriStrat good or VeriStrat poor. The research team hoped it would help predict how well treatment would work.

The aims of this trial were to see:

whether docetaxel or erlotinib is better for people who have a type of non small cell lung cancer called squamous cell cancer
how useful the VeriStrat test is

Summary of results

The results showed that there was little difference between erlotinib and docetaxel for advanced non small cell lung cancer. But that the VeriStrat test may help predict who was likely to live longer.

Results
This trial recruited 80 people with a type of non small cell lung cancer called squamous cell cancer. Everyone taking part had already had treatment that included platinum chemotherapy.

The research team had hoped more people would join the trial. But they found it quite difficult to recruit people so they closed the trial earlier than planned.

Of the 80 people who took part, there were:

38 in the erlotinib group – 28 VeriStrat good and 10 VeriStrat poor
42 in the docetaxel group – 30 VeriStrat good and 12 VeriStrat poor

The research team looked at how long it was before the cancer started to grow again. They found it was similar in the different groups.

They also looked at how long people lived for. They found there wasn’t much difference between the two treatments. But there was a difference between the two VeriStrat groups.

For the group classed as VeriStrat good it was:

7.8 months for those who had docetaxel
8.4 months for those who had erlotinib

For the group classed as VeriStrat poor it was:

4.4 months for those who had docetaxel
5.2 months for those who had erlotinib

When they looked at how many people had died in both treatment groups, they found it was nearly 7 out of 10 people (69%) who were VeriStrat good. And more than 9 out of 10 people (91%) who were VeriStrat poor.

Side effects
Most of the people taking part had at least one side effect:

36 out of 38 people who had erlotinib
39 out of 41 people who had docetaxel

Some of the side effects were mild or short lived. But 26 people had a more serious side effect:

7 people who had erlotinib
19 people who had docetaxel

There is more information about the side effects of erlotinib and docetaxel in our Cancer Drugs section.

Conclusion
The research team concluded that there was no difference in how well erlotinib and docetaxel worked for advanced non small cell lung cancer. But that people classed as VeriStrat good tended to live longer than those classed as VeriStrat poor.

We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists (peer reviewed Open a glossary item ) and published in a medical journal. The figures we quote above were provided by the trial team who did the research. We have not analysed the data ourselves.