title: Second- and third-line treatment of patients with non-small-cell lung cancer with erlotinib in the community setting: retrospective study of patient healthcare utilization and symptom burden.
abstract: BACKGROUND
  The purpose of this study was to describe treatment use patterns and outcomes with single-agent erlotinib among patients with advanced non-small-cell lung cancer (NSCLC) in the community oncology setting.
  
  
  METHODS
  Retrospective chart review identified patients treated with single-agent erlotinib as either second- or third-line therapy from 4 community oncology clinics. Medical records were extracted for medical outcomes and resource utilization. Patients reported outcome measures of symptom burden and functioning.
  
  
  RESULTS
  A total of 45 patients with stage IIIB/IV disease in second- (n = 27) or third-line (n = 18) therapy were 44% female and 84% white (16% black), with mean age of 66.7 years (SD, 9.2). Over 93% of the patients had previous platinum-based chemotherapy. Patients were treated with erlotinib for an average of 24 weeks. Dose reductions (24%) and treatment delays (29%) were due to skin reactions, diarrhea, and fatigue. The most common reasons for stopping erlotinib therapy were disease progression (53%), death (22%), and toxicities (11%). Patients' physical functioning improved during the first 3 months of erlotinib therapy. Hospitalizations (22%) were not due to erlotinib complications, and unplanned medical visits to the clinics were rare.
  
  
  CONCLUSIONS
  Data from this community sample were generally in agreement with the major clinical trial of erlotinib. Erlotinib is well tolerated by second- and third-line patients with advanced NSCLC in the community setting.
authors.affiliation: Accelerated Community Oncology Research Network, Memphis, TN 38138, USA.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Stepanski
authors.forename: Arthur C
authors.initials: AC
authors.lastname: Houts
authors.forename: Lee S
authors.initials: LS
authors.lastname: Schwartzberg
authors.forename: Mark S
authors.initials: MS
authors.lastname: Walker
authors.forename: Carolina M
authors.initials: CM
authors.lastname: Reyes
authors.forename: Johnetta
authors.initials: J
authors.lastname: Blakely
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002173:Cancer Care Facilities / Q000706:statistics & numerical data; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D003153:Community Health Services / Q000706:statistics & numerical data; D004305:Dose-Response Relationship, Drug; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011799:Quinazolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride