Analysis of treatment effects of erlotinib in non small cell lung cancer patients

Konference: 2009 34st Congress ESMO a 15th Congress ECCO - účast ČR

Kategorie: Zhoubné nádory plic a průdušek

Téma: Poster session V: Lung cancer

Číslo abstraktu: P-9133

Autoři: MUDr. Lenka Jakubíková, Ph.D.; MUDr. Marcela Tomíšková; prof. MUDr. Jana Skřičková, CSc.; B. Kaldec; MUDr. Jana Kaplanová; RNDr. Tomáš Pavlík, Ph.D.

Background: Erlotinib is an orally-active, EGFR-specific quinazoline TK inhibitor that demonstrated antitumour activity in xenograft models. We have had an opportunity to use erlotinib in 111 patients with NSCLC from the year of 2005. Here we provide an evaluation of treatment results in 110 patients evaluable for statistical analysis.
Methods: This is a retrospective analysis of the group of 111 patients with NSCLC, who started the treatment with erlotinib from October 2005 to December 2008. Clinical response was evaluated after 2 weeks of treatment. Objective response was evaluated by imaging techniques after 4–6 weeks of erlotinib treatment and had to be confirmed one month later (chest X-ray, CT scanning). At the same time changes of disease symptoms (dyspnea, cough, anorexia, fatique, pain) and adverse events were monitored.

Characteristics of patients: There were 65 men (58.6%) and 46 women (41.4%). Mean age was 61.0 years (27.0–86.0). Twenty three patiens (20.7%) were neversmokers, 64 (57.7%) former smokers and 22 (19.8%) smokers. Adenocarcinoma was diagnosed in 48 patiens (43.2%), bronchoalveolar carcinoma (BAC) in 10 (9.0%), squamous cell carcinoma in 37 (33.3%), NSCLC without further details in 13 (11.7%) and large cell carcinoma in 3 (2.7%). Performance status (PS) at the start of treatment was 0 in 12 patient (10.8%), 1 in 79 (71.1%) and 2 in 20 patients (18%). Erlotinib treatment was started after failure of preceding chemotherapy in almost all patients (93.5%).

Results: Only 36 from 111 patients (32.4%) have active therapy of erlotinib and they have therapeutical response. The treatment was stopped in 75 patients (67.6%) for progression of disease in 52 patients (68%), in 9 patients (12%) stopped for adverse events, eight patients (10.6%) died during follow up. In 50 patients (45.0%) was started therapy with erlotinib in second line therapy, in 54 patients (48.6%) in third line therapy, in 6 patients (5.4%) in first line therapy. Best objective response was PR in 13 patiens (11.7%) and SD in 45 (40.5%). Progression of the disease was found in 52 patients (46.8%). It was interesting that improvement in at least one of symptoms was noticed sooner than objective response. Median survival time was 5, 7 months from the beginning of erlotinib treatment for part of died patiens, while one-year live 33% patients and six month live 47.9% patients.

Conclusions: Our results are in comparison with published data. Several phase II and III clinical trials with 150 mg erlotinib testing its efficacy in advanced NSCLC patients have been performed. In 57 previously treated patients with EGFR-expressing NSCLC, the response rate (RR) to erlotinib was 12.3%. Responses were seen regardless of the number of prior chemotherapy regimens. The median survival was 8.4 months, and the 1-year survival was 40%. Till the present time there have been no method to determine the group of patient with NSCLC, that has clear benefit from erlotinib treatment.

Publikováno v: European Journal of Cancer Supplements, Vol 7 No 2, September 2009, Page 544

Datum přednesení příspěvku: 23. 9. 2009