A trial looking at radiotherapy with erlotinib for lung cancer that has spread to the brain (TACTIC)

The trial team found that having erlotinib alongside radiotherapy to the brain is not a useful treatment for non small lung cancer (NSCLC) that has spread to the brain. They also found that most people who took part did not have a specific change (EGFR mutation) in a lung cancer gene.

80 people with NSCLC that had recently spread to more than one area of the brain took part in this trial and,

• Half had radiotherapy to the brain and erlotinib tablets
• Half had radiotherapy to the brain and dummy tablets (placebo)

When radiotherapy finished, everybody continued taking erlotinib or the dummy drug to try and keep the cancer under control for longer. Doctors call this maintenance treatment.

A planned review of the results was done after the first 80 patients were recruited to decide if more people should take part.  When the researchers looked at the results, they found that the treatment hadn’t worked as well as they had hoped in enough patients. So, as planned, no more patients were recruited.

The trial team published their results in 2014.They followed up the people who took part for an average of one year after treatment. They looked at

• How long it was before the brain cancer got worse
• How long people lived for after treatment
• How treatment affected their quality of life

The researchers found no difference between the 2 groups in any of these. So, adding erlotinib was no more help than the standard treatment of radiotherapy alone to the brain.

The researchers found that erlotinb with radiotherapy was safe to give and the side effects were mild. The worst side effects reported from those having erlotinib were a skin rash and tiredness (fatigue).

Although erlotinib and radiotherapy didn’t appear to work for this group of patients, the researchers suggest that it should be looked at in future trials for people with a specific change (EGFR mutation) in a lung cancer gene.  

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