Healthcare | Sunday 17 May, 2015 11:21 am |

The newly introduced treatment improved overall survival benefit reaching median of 33 months in specific type of lung cancer patients 11 and their quality of lives in comparison to chemotherapy

• Lung Cancer has the highest mortality rate among other cancers globally, accounting for 1.60 million deaths in 20131. Around 1.8 million new lung cancer cases are detected annually.1
• From data estimated in 2008, there were 16,632 newly diagnosed lung cancer cases among the Arab league countries nationals. 13,826 cases (79.7%) of them were males and 2,806 (20.3%) were females4.
• Lung cancer is not just one disease. Non-small cell Lung Cancer (NSCLC) is the most common type of lung cancer, comprising over 85% of lung cancer cases.2 However, NSCLC has more than 10 identified molecular subsets, including EGFR, characterized by different genetic changes (known as mutations) present in the tumour.3
• Exon 19 deletions is the most common type of EGFR mutation. It accounts for 50% of all EGFR mutations.
• EGFR testing is recommended by oncologists to understand the mutations within the cell and provide the suitable targeted therapy.
• For patients with the exon 19 deletions, the new treatment from Boehringer Ingelheim prolonged median survival by 12.2 months versus chemotherapy in the LUX-Lung 3 trial, and 13.0 months versus chemotherapy in the LUX-Lung 6 trial.11 Median overall survival benefit reached 33.3 months with the new treatment versus 21.1 month for Chemotherapy in the same mutation 11 in Lux Lung 3 ((HR= 0.54,p=0.0015) and 31.4 months with the treatment vs 18.4 months with chemotherapy (HR=0.64, p=0.0229)
• Doctors say that EGFR Targeted Therapies aimed at treating these mutations is the latest medical introduction which can improve patient outcome.


- As part of its commitment to discovering and developing pioneering treatment options for cancer, Boehringer Ingelheim, a leading pharmaceutical company, organized an educational session in Dubai entitled, Oncology from Boehringer Ingelheim, where it launched the new therapeutic area and introduced the oncology franchise in the Middle East and North Africa (MENA) region. Experts in the field took this opportunity to discuss lung cancer disease and its various forms and highlighted the unmet challenges of Non-small cell Lung Cancer (NSCLC) treatment. The importance of EGFR testing and targeted therapies was also stressed. Boehringer Ingelheim presented its new treatment for EGFR mutation positive non-small cell lung cancer, which targets the cancer cells and is less harmful to normal cells; The Lux Lung 3 and Lux Lung 6 trials showed that the treatment increases the overall survival (especially in patients with exon 19 del), delays the tumor progression for the patients, and improves lung cancer related symptoms.

Globally, lung cancer is the most common cancer in the world. In the MENA region, the number of lung cancer incidences is on the rise, with over 16,000 newly diagnosed cases of which 79.9% were males and 20.3% were females.4 The available data on cancer burden in the Arab world indicate that incidence rates are increasing due to many factors such as aging, westernization of life style and continued population growth, demonstrating evidence that the cancer problem will continue in the future. Even with all the advances in understanding the disease and how to treat it, the 5-year relative survival rate in the region is only 8%.5

During Boehringer Ingelheim’s educational session, the doctors emphasized that lung cancer is not only one disease and can be categorized in two subtypes: NSCLC and small cell lung cancer (SCLC). NSCLC is the most common form worldwide with approximately 85%6,7 and can be further divided into three types. The experts also discussed the challenges of the treatment for NSCLC, since chemotherapy for an advanced level of this disease has reached a plateau. Therefore, they explained the importance of epidermal growth factor receptor (EGFR) testing and the benefits of targeted therapies, selective therapy able to act on specific molecular structures or according to the mutation subtype.

Dr. Anders Mellemgaard, Consultant in Unit of Thoracic Oncology, Herlev University Hospital in Copenhagen, Denmark stated, “Targeted therapies are essential in the treatment of distinct subtypes of NSCLC, specifically those targeted at EGFR mutations. In comparison to chemotherapy, targeted therapies, deliver their therapeutic effect directly to the cancer cell and therefore, are potentially less harmful to normal cells. In order to be able to determine the best form of treatment for the patients, we recommend using EGFR testing to better understand the mutations within the cell.”

“Lung cancer tumours develop when abnormal cells lining the air passages inside the lung tissue divide and grow faster than normal cells. Since the signs and symptoms take time to appear, approximately two-thirds of lung cancer patients present in a late, advanced stage when there is a very low rate of a cure.12,13 Therefore, as doctors in the field, we are collaborating with Boehringer Ingelheim in order to raise awareness about this disease and encourage people to have regular checkups in order to detect lung cancer in its early stages, ” added Dr. Mohammed Jaloudi, Chief of Medical Oncology, Tawam Hospital in Affiliation with John Hopkins Medicine, Al Ain, United Arab Emirates.

“We are excited to be introducing the new Boehringer Ingelheim therapeutic area for oncology in the MENA region, currently focusing on lung cancer” explained Dr. Sherif Khattab, Head of Oncology, Boehringer Ingelheim META. Khattab continued, “This new franchise establishment demonstrates Boehringer Ingelheim’s long-term commitment to providing advanced cancer therapies by discovering and developing innovative treatment options with the aim of bettering the lives of the patients and their families.”

The ErbB Family of receptors consists of four related enzymes called tyrosine kinases: EGFR (ErbB1), HER2 (ErbB2), ErbB3 and ErbB48, which greatly contribute to the growth and division of cells in many cancers9. The treatment by Boehringer Ingelheim irreversibly blocks these signals and aims to provide a sustained, selective and complete ErbB Family Blockade and therefore stopping the spread of the cancer cells.

Based on data from the pivotal LUX-Lung 3 and Lux Lung 6 trials sr and other Phase II and III trials in advanced non-small cell lung cancer patient population, this treatment allowed NSCLC patients with tumours harbouring the two most common EGFR mutations to live for well over a year without tumour progression (progression-free survival PFS of 13.6 months) versus just over half a year (PFS of 6.9 months) with the chemotherapy10. Del19 is the most common type of EGFR mutation and accounts for 50% of all EGFR mutations. For patients with the del19 mutation, the treatment prolonged median overall survival by 12.2 months versus chemotherapy in the LUX-Lung 3 trial, and 13.0 months versus chemotherapy in the LUX-Lung 6 trial.11 In turn, patients experienced better and longer control and improvement of the most common lung cancer-related symptoms, resulting in a better quality of life for the patients, in order for them to continue leading their lives as normally as possible.

” As a cancer support, education, and awareness consultant group in the UAE, we understand the complications, frustrations, and challenges that the patients feel on a daily basis whether in their personal or professional lives, especially during their treatment. We are pleased to see that Boehringer Ingelheim is spreading awareness about cancer and its various types, as well as helping educate the patients and their families about the treatment options available. This will allow them to manage their disease in a better way during and after the treatment. In addition, having a better understanding of the disease will allow the families and community members to better support the patients while battling this disease. We look forward to working with Boehringer Ingelheim and their team of experts in order to help improve the quality of life of our patients,” explained Ghadeer Kunna, a representative from Angels of Mercy, a Patient Advocacy Group specialized in Oncology.

With the launch of the new oncology therapeutic area in the MENA region, Boehringer Ingelheim will continue to focus its research in areas of unmet medical need and develop targeted therapies that will address the requirements of cancer patients in those countries.