title: Clinical retrospective analysis of erlotinib in the treatment of elderly patients with advanced non-small cell lung cancer.
abstract: In order to evaluate the clinical efficacy and the safety profile of molecularly targeted therapies as a palliative approach in elderly populations affected by advanced thoracic neoplasms, we retrospectively studied, in terms of effectiveness and toxicities, a group of pretreated elderly metastatic non-small cell lung cancer (NSCLC) patients admitted to our institution and treated with erlotinib at standard daily/dose. Forty-three patients aged 70 years or older who had previously failed on chemotherapy or radiotherapy were treated with oral Eerlotinib (150 mg/d) until disease progression or unacceptable toxicity. Clinical data, pathological types, potential prognostic factors, efficacy and toxicity of erlotinib were included in this analysis. In our series we observed: objective responses in six patients (14%) and stable disease in 15 (35%). Skin rash was the most common side effect (67%). Grade 3-4 adverse events were observed in 16 cases (37%). The median overall survival and the median progression-free survival were 8.4 months (CI 95%: 0.7-43.6) and 3 months (CI 95%: 0.4-28.4), respectively. Patients with adenocarcinoma achieved the best disease control rate (p = 0.027), while not/former smokers showed a better response (p = 0.069). In our experience the use of erlotinib after chemotherapy failure in an unselected elderly population affected by NSCLC showed moderate efficacy and a moderate safety profile. However, erlotinib represents a valid option in this setting, but other factors such as biological information, comorbidities and concomitant medications need to be carefully take into consideration in this particular subset of cancer patients.
authors.affiliation: Medical Oncology Unit 2, Fondazione IRCCS Istituto Nazionale dei Tumori, Via G. Venezian 1, 20133, Milan, Italy. om2@istitutotumori.mi.it
authors.forename: Marco
authors.initials: M
authors.lastname: Platania
authors.forename: Francesco
authors.initials: F
authors.lastname: Agustoni
authors.forename: Barbara
authors.initials: B
authors.lastname: Formisano
authors.forename: Milena
authors.initials: M
authors.lastname: Vitali
authors.forename: Monika
authors.initials: M
authors.lastname: Ducceschi
authors.forename: Filippo
authors.initials: F
authors.lastname: Pietrantonio
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Zilembo
authors.forename: Francesco
authors.initials: F
authors.lastname: Gelsomino
authors.forename: Sara
authors.initials: S
authors.lastname: Pusceddu
authors.forename: Roberto
authors.initials: R
authors.lastname: Buzzoni
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008297:Male; D010166:Palliative Care / Q000379:methods*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride