Second-line therapy in elderly patients with advanced nonsmall cell lung cancer

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Quoix, E. | Westeel, V. | Moreau, L. | Pichon, E. | Lavole, A. | Dauba, J. | Debieuvre, D. | Souquet, P. J. | Bigay-Game, L. | Dansin, E. | Poudenx, M. | Molinier, O. | Vaylet, F. | Moro-Sibilot, D. | Herman, D. | Sennelart, H. | Tredaniel, J. | Mennecier, B. | Morin, F. | Baudrin, L. | Milleron, B. | Zalcman, G.

Edité par CCSD ; European Respiratory Society -

International audience. 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 \textless/=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.

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