Phase II study of erlotinib for chemotherapy-naïve patients with advanced or metastatic non-small cell lung cancer who are ineligible for platinum doublets.
OBJECTIVE
This phase II study evaluated efficacy of single-agent erlotinib for chemotherapy-naïve patients with advanced/metastatic NSCLC who were ineligible for platinum doublets.


METHODS
Chemotherapy-naive patients but ineligible for platinum doublets (aged 18-75 with an ECOG performance status [PS] 2-3; or aged 76 or older with an ECOG PS 1-3) were enrolled and treated with erlotinib 100 mg once daily till disease progression, unacceptable toxicity or patient's refusal.


RESULTS
Out of 24 patients enrolled, 5 reached a PR, giving an overall response rate of 21%, but all responders were never-smokers with adenocarcinoma. According to EGFR mutation status, PR was observed in two of three patients having mutant EGFR (67%) but in one of nine having wild-type EGFR (11%). With a median follow-up of 22.6 months, the median progression-free and overall survival was 1.5 months and 3.2 months, respectively. All responders to post-erlotinib chemotherapy had responded to prior erlotinib.


CONCLUSIONS
For unselected chemotherapy-naïve Asian patients with NSCLC but ineligible for platinum doublets, empirical use of upfront erlotinib could not be recommended because of poor survival outcome. However, this can be given to selected subsets based on molecular or clinical predictors.
Lee
Dae Ho
DH
Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-2 dong, Songpa-gu, Seoul 138-736, Korea.
Kim
Sang-We
SW
Suh
Cheolwon
C
Han
Yun Hee
YH
Lee
Jung-Shin
JS
D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D044466:Asian People; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics; D000069347:Erlotinib Hydrochloride; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009362:Neoplasm Metastasis; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D013534:Survival; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors