title: The qualification of docetaxel or erlotinib for second-line therapy should be based on clinical and molecular predictive factors.
abstract: BACKGROUND
  We evaluated the effectiveness of docetaxel or erlotinib in second-line treatment of non-small cell lung cancer (NSCLC) and focused on the impact of predictive factors on the outcome of therapy.
  
  
  METHODS
  204 patients with progressive disease after platinum-based therapy were enrolled: 102 received an infusion of 75 mg/m(2) of docetaxel and 102 received 150 mg of erlotinib orally.
  
  
  RESULTS
  Response rate (RR) was 6.9 and 8.8% for docetaxel and erlotinib, respectively. Progression-free survival (PFS) was 1.2 months for docetaxel and 1.6 months for erlotinib (hazard ratio, HR = 1.2, p = 0.17). Overall survival was 5.5 versus 7 months for docetaxel and erlotinib, respectively (HR = 1.35, p = 0.06). Using Cox regression, we found clinical factors (performance status and weight loss) with predictive values for RR and PFS in second-line-treated patients. Prior radiotherapy, smoking status and EGFR mutation might help to predict outcome of erlotinib treatment and βIII-tubulin mRNA expression that of docetaxel, but histopathological diagnosis did not have any predictive value.
  
  
  CONCLUSIONS
  Erlotinib and docetaxel show similar efficacy in the treatment of NSCLC. The application of predictive factors may facilitate qualification for second-line treatment with both drugs.
authors.affiliation: Department of Pneumonology, Oncology and Allergology, Medical University of Lublin, Lublin, Poland. krapa@poczta.onet.pl
authors.forename: Paweł
authors.initials: P
authors.lastname: Krawczyk
authors.forename: Dariusz M
authors.initials: DM
authors.lastname: Kowalski
authors.forename: Kamila
authors.initials: K
authors.lastname: Wojas-Krawczyk
authors.forename: Radosław
authors.initials: R
authors.lastname: Mlak
authors.forename: Piotr
authors.initials: P
authors.lastname: Jaśkiewicz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Kucharczyk
authors.forename: Kinga
authors.initials: K
authors.lastname: Winiarczyk
authors.forename: Maciej
authors.initials: M
authors.lastname: Krzakowski
authors.forename: Janusz
authors.initials: J
authors.lastname: Milanowski
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D000077143:Docetaxel; D066246:ErbB Receptors / Q000235:genetics; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010984:Platinum / Q000627:therapeutic use; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011799:Quinazolines / Q000627:therapeutic use*; D012907:Smoking; D043823:Taxoids / Q000627:therapeutic use*; D014404:Tubulin / Q000235:genetics / Q000378:metabolism
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D043823:Taxoids; D014404:Tubulin; D000077143:Docetaxel; D010984:Platinum; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors