Second-line therapy in elderly patients with advanced nonsmall cell lung cancer
Elisabeth Quoix, Virginie Westeel, Lionel Moreau, Eric Pichon, Armelle Lavolé, Jérome Dauba, Didier Debieuvre, Pierre Jean Souquet, Laurence Bigay-Game, Eric Dansin, Michel Poudenx, Olivier Molinier, Fabien Vaylet, Denis Moro-Sibilot, Denis Herman, Helene Sennelart, Jean Tredaniel, Bertrand Mennecier, Franck Morin, Laurence Baudrin, Bernard Milleron, Gérard Zalcman, Intergroupe Francophone de Cancérologie Thoracique, P Masson, J-P Duhamel, Y Martinet, C Vidal, B Gentil-Lepecq, Pierre Bombaron, A Prevost, D Coëtmeur, C Galichet, S Labrune, M Zaegel, P Bonnefoy, J-M Vannetzel, N Paillot, J-L Pujol, J Meunier, B Stach, S Schneider, D Braun, L Gautier-Felizot, F Lebargy, P Nouyrigat, M Farny, C Sarda, F Martin, J Hermann, G Fraboulet, P Richard, S Friard, F Goutorbe, A Levy, Y Duval, M Angebault, P Charvolin, M Roa, M Vincent, S Larive, W Jacot, M Boutemy, N Le Flour, Elisabeth Quoix, Virginie Westeel, Lionel Moreau, Eric Pichon, Armelle Lavolé, Jérome Dauba, Didier Debieuvre, Pierre Jean Souquet, Laurence Bigay-Game, Eric Dansin, Michel Poudenx, Olivier Molinier, Fabien Vaylet, Denis Moro-Sibilot, Denis Herman, Helene Sennelart, Jean Tredaniel, Bertrand Mennecier, Franck Morin, Laurence Baudrin, Bernard Milleron, Gérard Zalcman, Intergroupe Francophone de Cancérologie Thoracique, P Masson, J-P Duhamel, Y Martinet, C Vidal, B Gentil-Lepecq, Pierre Bombaron, A Prevost, D Coëtmeur, C Galichet, S Labrune, M Zaegel, P Bonnefoy, J-M Vannetzel, N Paillot, J-L Pujol, J Meunier, B Stach, S Schneider, D Braun, L Gautier-Felizot, F Lebargy, P Nouyrigat, M Farny, C Sarda, F Martin, J Hermann, G Fraboulet, P Richard, S Friard, F Goutorbe, A Levy, Y Duval, M Angebault, P Charvolin, M Roa, M Vincent, S Larive, W Jacot, M Boutemy, N Le Flour
Abstract
There is no dedicated study on second-line treatment for elderly patients with advanced nonsmall cell lung cancer (NSCLC). We report the results on second-line erlotinib therapy from our previously published phase III study comparing single-agent therapy with platinum-based doublet (carboplatin plus paclitaxel) therapy in 451 elderly patients. Erlotinib was given to patients exhibiting disease progression or experiencing excessive toxicity during first-line therapy, until further progression or unacceptable toxicity. In total, 292 (64.7%) patients received erlotinib as second-line therapy. Initial performance status 0-1, stage IV NSCLC and an Activities of Daily Living score of 6 were independent factors for receiving erlotinib. Median (95% CI) overall survival was 4 (3.2-6.7) versus 6.8 (5.0-8.3) months in the single-agent and doublet arms, respectively (p=0.089). Performance status 0-1, never having smoked, adenocarcinoma and weight loss ≤5% were favourable independent prognostic factors of survival, whereas the randomisation arm had no significant impact. Among the 292 patients who received erlotinib, 60 (20.5%) experienced grade 3-4 toxic effects, the most frequent being rash. Erlotinib as second-line therapy is feasible, leading to efficacy results similar to those obtained in a previous randomised study that was not dedicated to elderly patients, with acceptable toxicity.
Trial registration: ClinicalTrials.gov NCT00298415.
Source: PubMed