Clinical Outcomes and Prognostic Factors Associated with the Response to Erlotinib in Non-Small-Cell Lung Cancer Patients with Unknown EGFR Mutational Status

Abstract

Background: The efficacy of erlotinib is controversial in patients with unknown EGFR mutational status. The aim of this study was to identify the clinicopathological factors that are predictive of erlotinob treatment outcomes for NSCLC patients with unknown EGFR mutational status. Materials and Methods: A retrospective analysis of 109 patients with advanced NSCLC who had previously failed at least one line of chemotherapy and received subsequent treatment with erlotinib (150 mg/day orally) was performed. A Cox proportional hazard model for univariate and multivariate analyses was used to identify the baseline clinical parameters correlating with treatment outcome, expressed in terms of hazard ratios (HRs) and 95% confidence intervals. Results: The median treatment duration was 15 weeks (range, 4-184). The disease control rate was 55%, including disease stability for ≥3 months for 40% of the patients. Median progression-free survival and median overall survival (OS) were 4.2 and 8.5 months, respectively. The Cox model indicated that an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2 (HR 3.82; p<0.001), presence of intra-abdominal metastasis (HR 3.42; p=0.002), 2 or more prior chemotherapy regimens (HR 2.29; p=0.021), and weight loss >5% (HR 2.05; p=0.034) were independent adverse prognostic factors for OS in NSCLC patients treated with erlotinib. Conclusions: This study suggests that NSCLC patients should be enrolled in erlotinib treatment after a first round of unsuccessful chemotherapy to improve treatment success, during which they should be monitored for intra-abdominal metastasis and weight loss.

Retrospective Analysis of Clinical Efficacy of Erlotinib in Patients with Non-Small Cell Lung Cancer

“…Therefore, we were able to achieve a 58.9% disease control rate (ORR + SD). Side effects were predictable and manageable, similar to those seen in previous erlotinib clinical trials [8,[11][12][13][14][15]. The median PFS and OS of the study population were 242 and 377 days, respectively, which were similar to those reported in other similar studies [8,[11][12][13][14][15].…”

Serum Carcinoembryonic Antigen Levels before Initial Treatment are Associated with EGFR Mutations and EML4-ALK Fusion Gene in Lung Adenocarcinoma Patients

“…The efficiency of EGFR-TKIs is unclear in patients without mutational analysis (Aydiner et al, 2013). Combined with the previous reports (Okamoto et al, 2005), which proved that the serum CEA level was an independent predictive factor of clinical efficacy of EGFRTKIs, patients with elevated serum CEA level before the initial treatment may be screened for EGFR-TKI treatment under the condition that we couldn't obtain specimens for gene detection.…”

Serum CEA Level Change and Its Significance Before and after Gefitinib Therapy on Patients with Advanced Non-small Cell Lung Cancer

“…There are hardly any favorable therapies for patients with middle and advanced NSCLC due to its increasing morbidity and mortality (Wu, 2012;Han et al, 2013;Liang et al, 2013). Genetic markers, tumor vessels and T cell receptors are frequently used as the targets of molecular targeted therapy for lung cancer, in which epidermal growth factor receptor (EGFR) is the major one at present (Aydiner et al, 2013;Tomonaga et al, 2013;Wheler et al, 2013). With the development of human immunology and molecular biology, people have gained profound recognition of tumor markers and targeted molecules with marvelous achievements.…”