
Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.
This trial looked at whether chemotherapy without platinum drugs worked better than platinum based chemotherapy for people with lung cancer. It was for people with a non small cell lung cancer (NSCLC) that had spread (advanced cancer).
Cancer Research UK supported this trial.
Surgery or radiotherapy are both treatments for NSCLC. But if your cancer is advanced when it is diagnosed you will probably have chemotherapy.
Chemotherapy for NSCLC usually includes a platinum drug such as cisplatin. But this type of chemotherapy helps some people more than others.
Platinum drugs damage the genetic material inside cells (the DNA). ERCC1 is a protein that helps to repair any damage to DNA.
Cancer cells may use ERCC1 to repair the damage caused by platinum drugs, which then allows the cancer to carry on growing. So it is possible that people with high levels of ERCC1 would do better having a different type of chemotherapy.
In this trial, some people had chemotherapy that included a platinum drug. Some had another type of chemotherapy. The researchers looked at everybody’s levels of ERCC1. They compared all the results from the 2 groups at the end of the trial.
The aims of the trial were to see:
The team found that for non small cell lung cancer chemotherapy including a platinum drug worked better than chemotherapy that didn’t. But there was little difference for people who have a non squamous cell lung cancer.
The level of ERCC1 made no difference to how well people did with any type of treatment.
This was a phase 3 trial. 648 people took part.
Researchers put people into 2 groups depending on whether their cancer was squamous cell or non squamous cell.
They also tested a sample of the cancer from everyone for the ERCC1 protein.
People who had squamous cell NSCLC
177 people who had squamous cell NSCLC were put into 1 of 2 groups by a computer (randomised).
The researchers looked at how well treatment worked (a response). They found the following numbers of people, whose cancer had the ERCC1 protein, responded to treatment:
For those whose cancer didn’t have the protein this was:
The team also looked at the average length of time that people lived after treatment. It was:
These results showed that cisplatin was much better than paclitaxel for people who had squamous cell NSCLC. So the that supervised the trial:
People who had non squamous cell NSCLC
471 people who had non squamous cell NSCLC were randomly put into 1 of 2 treatment groups:
The researchers looked at how many people responded to treatment. For those whose cancer had the ERCC1 protein this was:
For those whose cancer didn’t have the protein this was:
The average length of time people lived was:
Using ERCC1 protein results as a biomarker
The trial team also looked at the ERCC1 protein as a to try and predict how well the cancer responded and how long people lived after treatment. No difference was found between people whose cancer had the protein and those who didn’t.
The trial team concluded platinum based chemotherapy was best for advanced squamous cell NSCLC. The ERCC1 protein couldn’t be used to predict how well the cancer would respond to treatment or how long people might live after treatment.
We have based this summary on information from the research team. The information they sent us has been reviewed by independent specialists () 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.
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Prof Siow Ming Lee
Cancer Research UK
Experimental Cancer Medicine Centre (ECMC)
Eli Lilly and Company Limited
NIHR Clinical Research Network: Cancer
UCL Cancer Trials Centre
This is Cancer Research UK trial number CRUKE/08/021.
Freephone 0808 800 4040
Around 1 in 5 people diagnosed with cancer in the UK take part in a clinical trial.