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Longer NSCLC Progression-Free Survival With Erlotinib

Tied to longer progression-free survival for EGFR-positive NSCLC than standard chemo

FRIDAY, July 22 (HealthDay News) -- Treatment with erlotinib is associated with longer progression-free survival than standard chemotherapy for patients with advanced epidermal growth factor receptor (EGFR) mutation-positive non-small-cell lung cancer (NSCLC), according to a study published online July 22 in The Lancet Oncology.

Caicun Zhou, M.D., from the Tongji University in Shanghai, China, and colleagues compared the effectiveness and tolerability of erlotinib with standard chemotherapy in the first-line treatment of patients with advanced EGFR mutation-positive NSCLC. A total of 165 patients, aged older than 18 years, with confirmed stage IIIB or IV NSCLC and an activating mutation of EGFR were randomly assigned to receive either 150 mg/day of erlotinib (83 patients) until disease progression or unacceptable toxic effects, or chemotherapy of up to four cycles of gemcitabine plus carboplatin (82 patients). Progression-free survival was the primary outcome measure.

The investigators found that 82 patients in the erlotinib group and 72 in the chemotherapy group were included in the primary end point analysis. The median progression-free survival was significantly longer in the erlotinib group compared to the chemotherapy group (13.1 versus 4.6 months; hazard ratio, 0.16). There were more grade three or four toxic effects associated with chemotherapy, including neutropenia (30 patients) and thrombocytopenia (29) versus the erlotinib group (zero for both). Increased alanine aminotransferase concentration (three patients) and skin rash (two patients) were the most common effects observed with erlotinib. Increased treatment-related serious adverse events were observed in the chemotherapy group (eight decreased platelet counts, one decreased neutrophil count, and one hepatic dysfunction) compared to the erlotinib group (two hepatic dysfunction).

"Compared with standard chemotherapy, erlotinib conferred a significant progression-free survival benefit in patients with advanced EGFR mutation-positive NSCLC," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry, including F. Hoffmann-La Roche Ltd. (China), which partially funded this study.

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