We provide a comprehensive information, support and advocacy service for people affected by lung cancer throughout the UK.

Patients and Tarceva^® (erlotinib)

What is it?

Tarceva is the brand name for a new drug called erlotinib. This is a new type of anti-cancer drug which specifically attacks cancer cells which have a protein on the surface called the epidermal growth factor receptor (EGFR). This drug has been used to treat patients with non-small cell lung cancer with some success. The major benefit is that it can be given with very few side-effects compared to conventional chemotherapy.

Is it suitable for me?

Tarceva is only being used to treat people with non-small cell lung cancer (NSCLC). This type of lung cancer accounts for three quarters of all lung cancers.

This treatment may not be suitable for everyone with NSCLC. In the future it is hoped that genetic testing will be available to find out which patients this drug will work best for.

It can only be prescribed for patients with advanced non-small cell lung cancer, who have already had some chemotherapy and the cancer continues to grow. It must be prescribed by an oncologist (cancer specialist).

If you feel you may be suitable for Tarceva you should discuss it with your oncologist.

How does it work?

In the body, there are substances called growth factors that encourage cells to grow by dividing into new cells. Growth factors work by attaching on to structures, called receptors, on the surface of the cell. The growth factor and receptor then send a signal to the inside of the cell, telling it to start to grow. Cancer cells are often over sensitive to these growth factors which may be one of the reasons why a cancer grows out of control.

When Tarceva attaches to the growth factor receptor known as the epidermal growth factor receptor (EGFR), the signal telling the cancer cell to grow is switched off.

Tarceva works in a different way from both chemotherapy and hormonal therapy, and has fewer side effects. It is not a drug which is able to cure NSCLC, however, it may be possible to stop or slow down the growth of cancer cells.

Side-effects

All types of cancer treatment have side-effects of one sort or another. As Tarceva is a new drug, doctors may not know about all of the side-effects yet. The most common side-effect of Tarceva is a rash, which around three quarters of patients get. Other reported side-effects are: diarrhoea, feeling or being sick, dry eyes/mouth, tiredness, headache, and mouth pain.

Tell your doctor if you are experiencing any side-effects. If you have bad side-effects, your doctors may decide to give you a lower dose. Or you may stop treatment for a couple of weeks, and then start again.

How is it given?

Tarceva is a tablet which is taken once a day. It is taken for as long as it is felt that the treatment is working.

How do I get it?

NHS

In June 2006 the Scottish Medicines Consortium (SMC) passed this drug for use in Scotland. It is currently being offered to patients who have already received chemotherapy. Unfortunately it has not been approved for use in England and Wales by the regulatory medicines authorities (National Institute for Clinical Excellence, NICE). Therefore it is currently, only available in England and Wales in exceptional circumstances or as part of a Clinical Trial.

Clinical Trial within the NHS

Tarceva is still being tested in clinical trials in the UK. One of trials is called “TOPICAL”. The aim of this trial will be to compare Tarceva to a dummy tablet (placebo) for patients with advanced non-small cell lung cancer (NSCLC). The doctors want to find out how well Tarceva works for NSCLC, the effect it has on patients' quality of life, and more about the side-effects. This trial is particularly aimed at patients who are not suitable for the usual chemotherapy and who have not yet had any other treatment for their non-small cell lung cancer. For more information about this trial speak to your cancer specialist. You can also find out more about the clinical trial from the following website: www.cancerhelp.org.uk.

Private Consultation

Tarceva can be given privately either through a private insurance company or self-paying. This sometimes requires the drug to be given within the private care hospital and therefore add-on costs such as nursing care and pharmacy time have to be considered.

Other Information

On Monday 1st October 2007 NICE announced that they will reconsider the guidance on the use of the lung cancer drug Tarceva (Erlotinib) in the treatment of non-small cell lung cancer. This upheld a joint appeal by Cancerbackup and The Roy Castle Lung Cancer Foundation against their original decision in March not to approve the drug. In the meantime, as indicated by NICE, patients should not be denied access on the basis of their decision, as it is dependent on the appeals process.

If you would like more information on lung cancer please don’t hesitate to call The Roy Castle Lung Cancer Helpline on: 0800 358 7200.