Efficacy of erlotinib and its effects on the quality of life of older patients with epidermal growth factor receptor-mutant non-small cell lung cancer: A prospective, multicenter, dose-modification study.

Abstract

AIM:

Gefitinib and erlotinib are efficacious and safe for older patients with epidermal growth factor receptor-mutant non-small cell lung cancer. However, prolonged use of epidermal growth factor receptor-tyrosine kinase inhibitors in older patients is difficult, owing to potential adverse events. Hence, dose reduction or treatment discontinuation is often required. We investigated the efficacy of low-dose first-line erlotinib and its effects on the quality of life of older patients with lung cancer.

METHODS:

A prospective, multicenter, phase II clinical trial was carried out in patients aged ≥75 years with epidermal growth factor receptor-mutant non-small cell lung cancer. Initially, 100 mg/day erlotinib was administered orally; if well tolerated, it was increased to 150 mg/day. The primary end-point was progression-free survival, and secondary end-points were the response rate, overall survival and change in quality of life ("Care Notebook" questionnaire).

RESULTS:

The median progression-free survival was 17.8 months, response rate was 63.6% and median overall survival was 27.8 months. The change in the quality of life after 6 weeks was assessed in 72.7% of the patients. Fatigue, pain, anxiety and deterioration in daily activities were found in at least 40% of the patients. Despite the therapeutic effect of 100 mg/day erlotinib, many patients required dose reduction, and in some, the quality of life could not be maintained.

CONCLUSIONS:

Many older patients with epidermal growth factor receptor-mutant non-small cell lung cancer might require treatment dose reduction. Further studies are required to develop individualized treatments for older patients with lung cancer. Geriatr Gerontol Int 2021; 21: 881-886.

• Authors: Yukari Tsubata, Takeshi Masuda, Kosuke Hamai, Masaya Taniwaki, Akari Tanino, Takamasa Hotta, Megumi Hamaguchi, Shunichi Hamaguchi, Masahiro Yamasaki, Nobuhisa Ishikawa, Kazunori Fujitaka, Akihisa Sutani, Takeshi Isobe
• Journal: Geriatrics & gerontology international (Geriatr Gerontol Int) Vol. 21 Issue 10 Pg. 881-886 (Oct 2021) ISSN: 1447-0594 [Electronic] Japan
• PMID: 34378299 (Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study)
• Copyright: © 2021 The Authors. Geriatrics & Gerontology International published by John Wiley & Sons Australia, Ltd on behalf of Japan Geriatrics Society.

Chemical References

• Erlotinib Hydrochloride
• ErbB Receptors

Topics

• Aged
• Antineoplastic Combined Chemotherapy Protocols
• Carcinoma, Non-Small-Cell Lung (drug therapy, genetics)
• ErbB Receptors (genetics, therapeutic use)
• Erlotinib Hydrochloride (therapeutic use)
• Humans
• Lung Neoplasms (drug therapy, genetics)
• Mutation
• Prospective Studies
• Quality of Life