Erlotinib in previously treated non-small-cell lung cancer.
BACKGROUND
We conducted a randomized, placebo-controlled, double-blind trial to determine whether the epidermal growth factor receptor inhibitor erlotinib prolongs survival in non-small-cell lung cancer after the failure of first-line or second-line chemotherapy.


METHODS
Patients with stage IIIB or IV non-small-cell lung cancer, with performance status from 0 to 3, were eligible if they had received one or two prior chemotherapy regimens. The patients were stratified according to center, performance status, response to prior chemotherapy, number of prior regimens, and prior platinum-based therapy and were randomly assigned in a 2:1 ratio to receive oral erlotinib, at a dose of 150 mg daily, or placebo.


RESULTS
The median age of the 731 patients who underwent randomization was 61.4 years; 49 percent had received two prior chemotherapy regimens, and 93 percent had received platinum-based chemotherapy. The response rate was 8.9 percent in the erlotinib group and less than 1 percent in the placebo group (P<0.001); the median duration of the response was 7.9 months and 3.7 months, respectively. Progression-free survival was 2.2 months and 1.8 months, respectively (hazard ratio, 0.61, adjusted for stratification categories; P<0.001). Overall survival was 6.7 months and 4.7 months, respectively (hazard ratio, 0.70; P<0.001), in favor of erlotinib. Five percent of patients discontinued erlotinib because of toxic effects.


CONCLUSIONS
Erlotinib can prolong survival in patients with non-small-cell lung cancer after first-line or second-line chemotherapy.
Shepherd
Frances A
FA
Department of Medical Oncology, University Health Network, Princess Margaret Hospital Site, University of Toronto, Canada.
Rodrigues Pereira
José
J
Ciuleanu
Tudor
T
Tan
Eng Huat
EH
Hirsh
Vera
V
Thongprasert
Sumitra
S
Campos
Daniel
D
Maoleekoonpiroj
Savitree
S
Smylie
Michael
M
Martins
Renato
R
van Kooten
Maximiliano
M
Dediu
Mircea
M
Findlay
Brian
B
Tu
Dongsheng
D
Johnston
Dianne
D
Bezjak
Andrea
A
Clark
Gary
G
Santabárbara
Pedro
P
Seymour
Lesley
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D002945:Cisplatin / Q000008:administration & dosage; D004311:Double-Blind Method; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011788:Quality of Life; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D016019:Survival Analysis
D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors; D002945:Cisplatin