title: Erlotinib for metastatic non-small-cell lung cancer: first-, second- or third-line setting - does it matter ? A single-institution experience.
abstract: BACKGROUND
  Erlotinib is approved as treatment for metastatic non-small-cell lung cancer (NSCLC), following failure of initial therapy. Studies to define patients that derive maximal benefit from erlotinib have not dictated current practice.
  
  
  METHODS
  We retrospectively analyzed the prescription patterns and outcomes related to erlotinib use for NSCLC in a comprehensive cancer center.
  
  
  RESULTS
  Of 137 consecutive patients treated with erlotinib over 2 years, 116 were evaluable. Median age was 66 years, 63% females, most common histology was adenocarcinoma (n = 58). Seventy-nine patients presented with stage IIIB-IV disease, 37 with recurrent disease. There were 109 smokers. Erlotinib was given first line in 31 (27%), second line in 52 (45%) and third line in 33 (28%) patients. Daily erlotinib dose was 100 mg in 21 (18%) and 150 mg in 91 (82%) patients. Median duration of treatment was 8 weeks (range 1-72). Median overall survival (OS) from initiation of erlotinib was 5.4 months (range 0.2-27.8). There was no significant difference in median survival by disease stage (recurrent vs. de novo IIIB-IV) (p = 0.201), whether erlotinib was used as first-, second-, third-line therapy (p = 0.971) or at different doses (100 vs. 150 mg daily dose) (p = 0.579).
  
  
  CONCLUSIONS
  OS after erlotinib use was not different, whether used as first-, second- or third-line therapy, whether patients had recurrent metastatic NSCLC or de novo stage IV disease, or if erlotinib was used at a dose of 100 or 150 mg daily.
authors.affiliation: Department of Medicine, University of Michigan Comprehensive Cancer Center, Ann Arbor, Mich. 48109, USA.
authors.forename: Sikander
authors.initials: S
authors.lastname: Ailawadhi
authors.forename: Lyudmyla
authors.initials: L
authors.lastname: Derby
authors.forename: Raj
authors.initials: R
authors.lastname: Natarajan
authors.forename: Gerald
authors.initials: G
authors.lastname: Fetterly
authors.forename: Mary
authors.initials: M
authors.lastname: Reid
authors.forename: Nithya
authors.initials: N
authors.lastname: Ramnath
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D047428:Protein Kinase Inhibitors / Q000494:pharmacology*; D011799:Quinazolines / Q000494:pharmacology*; D012189:Retrospective Studies
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride