1347 - EGFR-tyrosine kinase inhibitor treatment beyond progression in long-term responders to erlotinib in advanced non-small cell lung cancer: relevance o...

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Biomarkers
Non-Small-Cell Lung Cancer, Metastatic
Presenter Martin Faehling
Authors M. Faehling1, R. Eckert2, T. Kamp3, J. Sträter4, G. Ott5, W. Spengler6
  • 1Klinik Für Kardiologie Und Pneumologie, Klinikum Esslingen, 73730 - Esslingen/DE
  • 2Oncology Group Practice, 73240 - Wendlingen/DE
  • 3Oncology, Oncology Group Practice, Wendlingen/DE
  • 4Pathologie, Institut für Pathologie, 73730 - Esslingen/DE
  • 5Pathology, Robert Bosch Krankenhaus, 70376 - Stuttgart/DE
  • 6Medizinische Klinik Ii, Universitätsklinik Tübingen, 72076 - Tübingen/DE

Abstract

Introduction

Some patients with advanced NSCLC show prolonged disease stabilization on treatment with an EGFR-tyrosine kinase inhibitor (TKI) such as erlotinib. It is not clear how to treat patients who progress after prolonged response to erlotinib. We hypothesized that TKI therapy beyond progression with added chemotherapy, radiotherapy or best supportive care may improve survival.

Patients and methods

We retrospectively analyzed all NSCLC patients treated with erlotinib at our institutions since 2004 who progressed after at least stable disease on erlotinib for at least six months. The first 16 patients did not receive further TKI treatment after progression (controls). The following 25 patients were treated with TKI beyond progression (TKI patients). Overall survival (OS) was analyzed for the whole population, a case-control analysis of pairs matched for gender, smoking status, histology, best response to first TKI therapy, and therapy line. Furthermore, OS of patients with known EGFR-mutation status (n = 24) and those treated with pemetrexed (n = 21) is reported.

Results

Treatment with TKI and chemotherapy was well tolerated. TKI-patients had a significantly longer OS from progression on TKI (case control: median 14.5 vs. 2.0 months, HR 0.154) and longer OS from diagnosis of lung cancer (case control: median 54.5 vs. 28.3 months, HR 0.474). Patients with an activating EGFR mutation had prolonged survival compared with patients without an activating EGFR mutation. However, both in patients with and without an activating EGFR mutation, patients treated with erlotinib beyond progression had a longer survival.

Conclusions

In our case-control analysis in long-term erlotinib responders, treatment with TKI beyond progression in addition to chemotherapy or radiotherapy was feasible and lead to prolonged overall survival. A prolonged survival with erlotinib beyond progression was observed in both EGFR-mutation positive and negative long-term responders to erlotinib.

Disclosure

All authors have declared no conflicts of interest.