Erlotinib treatment after platinum-based therapy in elderly patients with non-small-cell lung cancer in routine clinical practice – results from the ElderTac study

Abstract

BackgroundIn this prospective non-interventional study, the effectiveness and tolerability of erlotinib in elderly patients with non-small-cell lung cancer (NSCLC) after ≥1 platinum-based chemotherapy were assessed.MethodsA total of 385 patients ≥65 years of age with advanced NSCLC receiving erlotinib were observed over 12 months. The primary endpoint was the 1-year overall survival (OS) rate.ResultsPatients were predominantly Caucasian (99.2%), a mean of 73 years old; 24.7% had an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2. Most common tumor histologies were adenocarcinoma (64.9%) and squamous cell carcinoma (22.3%). Of 119 patients tested, 15.1% had an activating epidermal growth factor receptor gene (EGFR) mutation. The 1-year OS rate was 31% (95% CI 25–36) with a median OS of 7.1 months (95% CI 6.0–7.9). OS was significantly better in females than males (p = 0.0258) and in patients with an EGFR mutation compared to EGFR wild-type patients (p = 0.0004). OS was not affected by age (p = 0.3436) and ECOG PS (p = 0.5364). Patients with squamous NSCLC tended to live longer than patients with non-squamous EGFR wild-type tumors (median OS: 8.6 vs 5.5 months). Cough and dyspnea improved during the observation period. The erlotinib safety profile was comparable to that in previous studies with rash (45.2%) and diarrhea (22.6%) being the most frequently reported adverse events.ConclusionsErlotinib represents a suitable palliative treatment option in further therapy lines for elderly patients with advanced NSCLC. The results obtained under real-life conditions add to our understanding of the benefits and risks of erlotinib in routine clinical practice.Trial registrationBfArM (https://www.bfarm.de; ML23023); ClinicalTrials.gov (NCT01535729; 20 Feb 2012).

Clinicopathological characteristics and prognosis of pulmonary large cell neuroendocrine carcinoma aged ≥65 years

“…Median age at diagnosis of all patients was 66 years (range, 18–94 years). Using median age and previous clinical studies as guides (Brueckl et al, 2018; Feliciano et al, 2018; Hutchins et al, 1999; Lembicz et al, 2018; Lewis et al, 2003), we divided the included patients into two groups based on age: younger (aged <65 years) ( N = 729), and older (aged ≥65 years) ( N = 890) patients.…”

“…The incidence of pulmonary LCNEC is rare, representing only 3% of all types of diagnosed lung cancer. Thus, the published studies of pulmonary LCNEC commonly included limited patients (Brueckl et al, 2018; Carretta et al, 2000; Mazieres et al, 2002; Zacharias et al, 2003). In this study, we found that more LCNEC patients were white, married, of stage I, with tumor size <5 cm in the older group; and the proportion of patients undergoing surgery, radiotherapy, and chemotherapy were significantly lower.…”

SFRP2 modulates non‑small cell lung cancer A549�cell apoptosis and metastasis by regulating mitochondrial fission via Wnt pathways

“…non-small cell lung cancer (nSclc) is a lung malignancy that seriously threatens human health, and its poor prognosis largely results from cancer cell survival and metastasis (1)(2)(3). The methods of radiotherapy and chemotherapy used to treat nSclc have improved; however, the 5-year survival of patients with nSclc remains poor (4)(5)(6)(7). Therefore, strategies that suppress cancer cell survival and metastasis are required for the treatment of nSclc.…”

Molecular Profile of Advanced Non-Small Cell Lung Cancers in Octogenarians: The Door to Precision Medicine in Elderly Patients

“…Although these series included patients ranging from 24 to 88 years old, the elderly were underrepresented and specific data regarding octogenarians are limited. Previous studies have reported on the safety and efficacy of TKIs in elderly patients, as shown by osimertinib treatment for T790M-positive NSCLC [36] or erlotinib treatment for NSCLC after one or more platinum-based chemotherapy regimens [37]. However, the definition of “elderly” is highly heterogeneous among these studies, including patients ranging from 65 [37] to 75 years old [36].…”

“…Previous studies have reported on the safety and efficacy of TKIs in elderly patients, as shown by osimertinib treatment for T790M-positive NSCLC [36] or erlotinib treatment for NSCLC after one or more platinum-based chemotherapy regimens [37]. However, the definition of “elderly” is highly heterogeneous among these studies, including patients ranging from 65 [37] to 75 years old [36]. Recently, a multicenter real-world study (OCTOMUT) evaluated the tolerability and efficacy of TKIs in Caucasian octogenarian patients with EGFR -mutated NSCLC [38].…”