Evidences suggested that combined blockade of the
VEGF and EGFR pathways can improve the treatment efficacy of
non-small-cell lung cancer (NSCLC). In our previously clinical practice, we observed that
thalidomide, a potent
VEGF inhibitor, can significantly decrease the
tumor size of one EGFR-TKI resistance patient with
lung cancer cachexia. In this pilot study, we tried to assess the efficacy and toxicity of the combination
therapy of
erlotinib and
thalidomide in advanced NSCLC patients with acquired resistance to
erlotinib. In all, 52 NSCLC patients with drug resistance to
erlotinib were recruited and treated with this combination
therapy.
After treatment, 4 patients presented with partial remission (PR), 16 with stable disease (SD) and 32 with progressive disease (PD). The objective response rate (ORR) and disease control rate (DCR) was 7.7% and 38.5%, respectively. In this study, we firstly confirmed that
thalidomide can reversion of
erlotinib-acquired resistance with
a 7 weeks median progression-free survival (PFS); besides, this combination
therapy shows acceptable drug tolerance; the most common drug related adverse events were astriction,
numbness and sleeve-like feeling in the limbs, no
thrombosis occurred in any patient. Those evidences indicate that
thalidomide may be a useful candidate for reversion of
erlotinib-acquired resistance.