title: Are EGFR tyrosine kinase inhibitors effective in elderly patients with EGFR-mutated non-small cell lung cancer?
abstract: EGFR tyrosine kinase inhibitors (TKIs) such as erlotinib, gefitinib, and afatinib changed dramatically the history of metastatic non-small cell lung cancer (NSCLC) harbouring EGFR mutations. However, not enough data are available on the efficacy of these targeted drugs in elderly patients. The aim of this study is to analyse the available clinical data evaluating the efficacy of anti-EGFR therapies in elderly patients with advanced NSCLC carrying EGFR mutations. A literature-based meta-analysis of the results of randomized clinical trials was undertaken. Relevant publications from PubMed, the Cochrane Library, and abstracts from American Society of Clinical Oncology meetings were searched. Progression-free survival (PFS), as a measure of the efficacy of treatment, was the primary outcome investigated. The pooled analysis revealed an overall significant improvement in PFS (HR = 0.44, 95% CI 0.28-0.69; p = 0.0004) with the use of EGFR TKIs in EGFR-mutated NSCLC. The data stratification per age subgroups showed that EGFR TKIs were more effective in prolonging PFS in elderly patients, with HR 0.39 (p = 0.008), in comparison with young patients (HR = 0.48; p = 0.04). The results of this study suggest that EGFR TKIs have a significant effect in slowing down diseases progression in elderly patients with advanced NSCLC, therefore representing a valid therapeutic option in this age group.
authors.affiliation: Department of Molecular and Translational Medicine, University of Brescia, 25123, Brescia, Italy. giandomenicoroviello@gmail.com.|Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy. giandomenicoroviello@gmail.com.|Medical Oncology Unit, Department of Oncology, San Donato Hospital, Via Nenni 20, 52100, Arezzo, Italy. giandomenicoroviello@gmail.com.
authors.forename: Giandomenico
authors.initials: G
authors.lastname: Roviello
authors.affiliation: Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Zanotti
authors.affiliation: Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy.
authors.forename: Maria Rosa
authors.initials: MR
authors.lastname: Cappelletti
authors.affiliation: Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy.
authors.forename: Angela
authors.initials: A
authors.lastname: Gobbi
authors.affiliation: Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Dester
authors.affiliation: Unit of General Medicine, Azienda Ospedaliera "C. Poma" Presidio ospedaliero di Pieve di Coriano, Mantua, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Paganini
authors.affiliation: Unit of Radiotherapy, Department of Medical, Surgical Sciences and Neurosciences, Siena University, Viale Bracci 11, 53100, Siena, Italy.
authors.forename: Chiara
authors.initials: C
authors.lastname: Pacifico
authors.affiliation: Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy.|Department of Medical, Surgery and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Generali
authors.affiliation: Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Raheleh
authors.initials: R
authors.lastname: Roudi
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D066246:ErbB Receptors / Q000235:genetics* / Q000378:metabolism*; D006801:Humans; D050505:Mutant Proteins / Q000235:genetics / Q000378:metabolism; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D050505:Mutant Proteins; D047428:Protein Kinase Inhibitors; C512478:EGFR protein, human; D066246:ErbB Receptors; D011505:Protein-Tyrosine Kinases
keywords: Afatinib; EGFR; Elderly; Erlotinib; Gefitinib