In a nutshell
This trial aimed to assess the effectiveness of using erlotinib (Tarceva) to treat EGFR-mutation positive advanced non-small-cell lung cancer. The study concluded that erlotinib had an overall survival (OS) benefit comparable to first line chemotherapy.
Some background
Genetic mutations (changes) in the epidermal growth factor receptor (EGFR) can lead to NSCLC. EGFR tyrosine kinase inhibitors (EGFR TKIs), including erlotinib, are drugs used to block the activity of these receptors. EGFR TKIs could potentially be beneficial in treating EGFR-mutation positive advanced NSCLC. A previous trial showed that there was improved progression free survival (time from treatment until disease progression) and quality of life in patients treated with erlotinib compared to chemotherapy. It is not clear whether there is also an overall survival (OS) benefit.
Methods & findings
154 patients with EGFR-mutation positive advanced NSCLC were randomized into two groups. 82 patients in group 1 were treated with erlotinib while 72 patients in group 2 were treated with chemotherapy. Patients underwent regular follow ups until disease progression and death.
The average OS for group 1 was 22.8 months, compared to 27.2 months for group 2. There was an increased OS for patients who received sequential treatment (one treatment followed by the other). Patients first treated with erlotinib followed by chemotherapy had an average OS of 28 months while patients first treated with chemo followed by erlotinib had an average OS of 32 months.
The bottom line
The authors concluded that erlotinib had an OS benefit. They suggested that it should be considered as a first line treatment for EGFR-mutation positive NSCLC.
The fine print
This study received funding from F. Hoffman-La Roche, the manufacturers of erlotinib.
Published By :
Annals of oncology
Date :
Jul 03, 2015
