title: Second-line therapy in elderly patients with advanced nonsmall cell lung cancer.
abstract: There is no dedicated study on second-line treatment for elderly patients with advanced nonsmall cell lung cancer (NSCLC). We report the results on second-line erlotinib therapy from our previously published phase III study comparing single-agent therapy with platinum-based doublet (carboplatin plus paclitaxel) therapy in 451 elderly patients. Erlotinib was given to patients exhibiting disease progression or experiencing excessive toxicity during first-line therapy, until further progression or unacceptable toxicity. In total, 292 (64.7%) patients received erlotinib as second-line therapy. Initial performance status 0-1, stage IV NSCLC and an Activities of Daily Living score of 6 were independent factors for receiving erlotinib. Median (95% CI) overall survival was 4 (3.2-6.7) versus 6.8 (5.0-8.3) months in the single-agent and doublet arms, respectively (p=0.089). Performance status 0-1, never having smoked, adenocarcinoma and weight loss ≤5% were favourable independent prognostic factors of survival, whereas the randomisation arm had no significant impact. Among the 292 patients who received erlotinib, 60 (20.5%) experienced grade 3-4 toxic effects, the most frequent being rash. Erlotinib as second-line therapy is feasible, leading to efficacy results similar to those obtained in a previous randomised study that was not dedicated to elderly patients, with acceptable toxicity.
authors.affiliation: CHU Strasbourg, Strasbourg.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Quoix
authors.forename: Virginie
authors.initials: V
authors.lastname: Westeel
authors.forename: Lionel
authors.initials: L
authors.lastname: Moreau
authors.forename: Eric
authors.initials: E
authors.lastname: Pichon
authors.forename: Armelle
authors.initials: A
authors.lastname: Lavolé
authors.forename: Jérome
authors.initials: J
authors.lastname: Dauba
authors.forename: Didier
authors.initials: D
authors.lastname: Debieuvre
authors.forename: Pierre Jean
authors.initials: PJ
authors.lastname: Souquet
authors.forename: Laurence
authors.initials: L
authors.lastname: Bigay-Game
authors.forename: Eric
authors.initials: E
authors.lastname: Dansin
authors.forename: Michel
authors.initials: M
authors.lastname: Poudenx
authors.forename: Olivier
authors.initials: O
authors.lastname: Molinier
authors.forename: Fabien
authors.initials: F
authors.lastname: Vaylet
authors.forename: Denis
authors.initials: D
authors.lastname: Moro-Sibilot
authors.forename: Denis
authors.initials: D
authors.lastname: Herman
authors.forename: Helene
authors.initials: H
authors.lastname: Sennelart
authors.forename: Jean
authors.initials: J
authors.lastname: Tredaniel
authors.forename: Bertrand
authors.initials: B
authors.lastname: Mennecier
authors.forename: Franck
authors.initials: F
authors.lastname: Morin
authors.forename: Laurence
authors.initials: L
authors.lastname: Baudrin
authors.forename: Bernard
authors.initials: B
authors.lastname: Milleron
authors.forename: Gérard
authors.initials: G
authors.lastname: Zalcman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D018450:Disease Progression; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D000069347:Erlotinib Hydrochloride; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011799:Quinazolines / Q000627:therapeutic use*; D017211:Treatment Failure; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors