Erlotinib may be an effective therapeutic option for patients with pretreated advanced non-small cell lung cancer (NSCLC) and no known molecular alterations, according to a study published in the journal Lung Cancer.
The use of erlotinib in patients with EGFR wildtype, advanced NSCLC, remains controversial; therefore, researchers conducted a propensity-adjusted, outcomes research-based study to compare the efficacy of chemotherapy and erlotinib in this patient population.
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The study looked at patients with advanced NSCLC who were receiving at least two lines of palliative systemic treatment between January 2005 and December 2014 and did not harbor any targetable driver mutations. The primary study endpoint was overall survival, with a secondary endpoint of progression-free survival.
Among 227 patients included in the study, 125 received erlotinib in the second (n=89), third (n=28) or further-line (n=8), while 102 patients received chemotherapy only.
Using Kaplan-Meier statistics, multivariate Cox regression, and propensity score or Inverse Probability Weights to compare clinical outcomes between the two patient groups, researchers found that both overall survival (hazard ratio, 1.14; 95% CI, 0.80-1.63; P = .448) and progression-free survival (hazard ratio, 1.20; 95% CI, 0.95-1.52; P = .119) were similar regardless of which treatment was used.
However, the researchers did note that women and never smokers were significantly overrepresented in the erlotinib group. Additionally, Eastern Cooperative Oncology Group performance status was the most significant covariate when selecting patients for erlotinib treatment.
From these results, researchers concluded that erlotinib and chemotherapy have similar clinical efficacy in patients with pretreated advanced NSCLC and no known molecular alterations.
