Efficacy and safety of erlotinib in elderly patients with lung cancer adenocarcinoma
|Date||28 March 2014|
|Session||Lunch and poster display session|
|Topics|| Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
|Citation||Journal of Thoracic Oncology (2014) 9 (Supplement 9): S7-S52. 10.1097/JTO.0000000000000131|
K.N. Syrigos, P. Boura, D. Vassos, A. Vassias, A. Bastas, A. Boufas, I. Gkiozos
Besides chemotherapy, Erlotinib is another option in NSCLC patients especially in those with EGFR mutations. Elderly patients enrolled in trials are fit without co-morbidities, but in clinical practice most suffer from co-morbidities.
Medical records of 1221 patients diagnosed with NSCLC between 2008-2012 were screened. We examined patients ≥75 years for demographics, clinical data and Treatment details.
233/1221 NSCLC patients received erlotinib at any line. 53/233 (23%) were ≥75 years old. Male:female ratio was 34:19 and median age 79 years (range 75-88). NSCLC subtypes included 31 adenoca, 8 squamous cell, 9 NOS and 5 others. 50/53 patients had co-morbidities (≥2 in 46 patients, 1 in 4 patients). Main co-morbidities were cardiovascular disease (n=41), COPD (n=14), other cancer (n=10) and diabetes (n=8). 8 patients were tested for EGFR mutations (5 negative, 3 positive). Performance Status was satisfactory (ECOG 0-1) in 8 patients and poor (2-3) in 45 patients. 8 patients were treated with erlotinib 100mg and 45 patients with erlotinib 150mg (12 patients needed dose reduction). Complete follow up data were found in 46 patients. Mean duration of treatment was 79 days (range 9-662). 35/46 patients experienced side effects [rash n=29, diarrhea n=17] which led to treatment discontinuation in 12 patients. Patients with abnormal creatinine clearance (n=13) were more likely to stop treatment due to side effects (6/13 versus 6/33). 17/46 patients (37%) achieved disease control (5 PR –partial response, 12 SD- stable disease) and a time to progression (TTP) of 157 days (range 106-662, 95% CI 132.79-270,74) while 22/46 patients had PD as best response (TTP 49days, range 19-88, CI 44,67-64,97). 7patients were not evaluable (stopped Treatment due to side effects). All EGFR positive patients had disease control (2PR, 1SD).
Erlotinib is a valuable option in elderly NSCLC patients with co-morbidities, especially if they harbor EGFR mutations. Impaired renal function might be associated with propensity to side effects and early treatment discontinuation.
All authors have declared no conflicts of interest.