A multicenter phase II randomized trial of gemcitabine followed by erlotinib at progression, versus the reverse sequence, in vulnerable elderly patients with advanced non small-cell lung cancer selected with a comprehensive geriatric assessment (the GFPC 0505 study)

Lecaer, H.; Greillier, L.; Corre, Romain; Jullian, H.; Créquit, Jacky; Falchero, L.; Dujon, C.; Bérard, H.; Vergnenègre, A.; Chouaïd, C.

doi:10.1016/j.lungcan.2012.02.004

Cited by 22 publications

(17 citation statements)

References 32 publications

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“…The ipass trial demonstrated significant improvements in response rate and pfs, but no difference in os 36 . No significant outcome differences were observed in the other two trials 38,39 . Subgroup analyses for the ipass and First-signal trials were done for patients with tumour samples available for EGFR mutation testing 36,38 .…”

Section: Clinically Selected Populationsmentioning

confidence: 71%

Use of the Epidermal Growth Factor Receptor Inhibitors Gefitinib, Erlotinib, Afatinib, Dacomitinib, and Icotinib in the Treatment of Non-Small-Cell Lung Cancer: A Systematic Review

et al. 2015

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Section: Clinically Selected Populationsmentioning

confidence: 71%

Use of the Epidermal Growth Factor Receptor Inhibitors Gefitinib, Erlotinib, Afatinib, Dacomitinib, and Icotinib in the Treatment of Non-Small-Cell Lung Cancer: A Systematic Review

et al. 2015

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“…GFPC 0504 involved fit patients (15) and GFPC 0505 frail patients (16), as identified with a CGA. Both trials compared first-line chemotherapy (gemcitabine plus docetaxel for fit patients, gemcitabine alone for frail patients) followed by second-line erlotinib versus the reverse strategy (erlotinib followed by chemotherapy).…”

Section: Datamentioning

confidence: 99%

“…In elderly patients with advanced-stage NSCLC, several phase II trials and a large phase III trial failed to show a clear benefit of using the CGA for allocation treatment (5,(15)(16)(17)(18)(19). In addition, the CGA has been criticised for being time-consuming, cumbersome and not standardised, and its real influence on treatment decisions in clinical practice has been questioned (12).…”

Section: Introductionmentioning

confidence: 99%

Prognostic role of a comprehensive geriatric assessment on the management of elderly patients with advanced non-small cell lung cancer (NSCLC): a pooled analysis of two prospective phase II trials by the GFPC Group

Caer

Borget

Corre³

et al. 2017

J. Thorac. Dis.

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Background:The prognostic role of a comprehensive geriatric assessment (CGA) on the management of elderly patients with advanced-stage non-small cell lung cancer (NSCLC) remains to be established. The objective of this analysis was to determine the prognostic role of each CGA domain on overall survival (OS) among elderly patients with advanced-stage NSCLC.Methods: We pooled individual data from two prospective, randomized phases II trials in patients over 65 years old with advanced-stage NSCLC, who were considered fit (0405 trial) or no-fit (0505 trial) based on a CGA. Both trials compared first-line chemotherapy followed by second-line erlotinib with the reverse strategy in terms of progression-free survival (PFS) and OS. Factors prognostic of OS were sought by using the KaplanMeier method and the log rank test for univariate analysis, and a Cox model for multivariate analysis. were close to significance.Conclusions: PS and comorbidities appear to be the main predictors of OS in elderly advanced NSCLC patients selected on the basis of CGA.

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“…In one series of 97 vulnerable elderly patients with advanced NSCLC who were not selected for by EGFR expression, the activity of weekly gemcitabine followed by erlotinib at disease progression versus the reverse sequence was evaluated. Each strategy proved feasible, but with modest efficacy, producing similar results in terms of OS, and time to first and second progression (20).…”

Section: Activity Of Gefitinib and Erlotinibmentioning

confidence: 99%

“…The majority of significant retrospective data are obtained by subgroup analysis of elderly patients from the large studies performed without age restriction (12)(13)(14). To date, a lower contribution has been provided from prospective studies specifically designed to evaluate the efficacy and safety of molecular-targeted drugs in elderly patients with NSCLC (15)(16)(17)(18)(19)(20)(21). The aim of the present review is to summarize the current data on the efficacy and safety of molecular-targeted therapy in elderly patients with advanced NSCLC.…”

Section: Introductionmentioning

confidence: 99%

Molecular-targeted therapy for elderly patients with advanced non-small cell lung cancer

et al. 2015

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Abstract. Lung cancer is the most common cause of cancer-related mortality in men and women. Non-small cell lung cancer (NSCLC) represents close to 90% of all lung cancers. When diagnosed, >50% of patients are >65 years old. Through an improved understanding of the molecular mechanisms involved in lung oncogenesis, molecular-targeted approaches have become an essential element for the treatment of patients with NSCLC. As the toxicity profiles of the techniques are definitely more favorable compared with chemotherapy, they are particularly attractive for use in elderly patients, who are potentially more susceptible to the toxicity of systemic oncological therapies. However, studies on the activity of molecular-targeted agents in this aged patient setting are much more limited compared with those in their younger counterparts. In the present review, the literature on molecular-targeted therapy for elderly patients with advanced NSCLC is discussed. It is concluded that bevacizumab should be reserved only for highly select elderly patients with advanced NSCLC when the clinician deems it useful in the face of acceptable toxicities. In elderly patients with advanced epidermal growth factor receptor mutation-positive NSCLC, erlotinib and gefitinib appear to repeat the same favorable performance as that documented on a larger scale in the overall population of patients with activating mutations. A good toxicity profile is also confirmed for active molecules on different pathways, such as crizotinib. IntroductionThe 'elderly' patient with lung cancer treated with cytotoxic chemotherapy has been the subject of several studies that have assumed international importance due to sample size, methodological rigor and impact on clinical practice. Confirmed by evidence-based medicine, these important trials have led to the definition of therapeutic standards validated in this patient subset: The ELVIS study showed the superiority of vinorelbine over placebo (1); the MILES study showed a similar effectiveness between single-agent vinorelbine or gemcitabine, and single-agent efficacy over the combination of vinorelbine plus gemcitabine (2); the MILES 2P study showed better survival for cisplatin plus gemcitabine compared with cisplatin plus vinorelbine (3); the IFCT-0501 study showed survival benefits with carboplatin plus weekly paclitaxel compared with vinorelbine or gemcitabine monotherapy (4); another study showed improved survival with platinum-based adjuvant chemotherapy (5); and in a phase II trial involving elderly patients with advanced-stage small cell lung cancer, the weekly regimen of gemcitabine and docetaxel demonstrated no advantage over standard therapy (6).The last decade of research in this field has witnessed the emergence of molecular-targeted therapies as an essential element for the treatment of patients with non-small cell lung cancer (NSCLC) (7). The studies on the activity of these novel therapies in the elderly patient with NSCLC are few (8,9), comprising a more fragmented and less numerous casuistry tha...

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A multicenter phase II randomized trial of gemcitabine followed by erlotinib at progression, versus the reverse sequence, in vulnerable elderly patients with advanced non small-cell lung cancer selected with a comprehensive geriatric assessment (the GFPC 0505 study)

Cited by 22 publications

References 32 publications

Use of the Epidermal Growth Factor Receptor Inhibitors Gefitinib, Erlotinib, Afatinib, Dacomitinib, and Icotinib in the Treatment of Non-Small-Cell Lung Cancer: A Systematic Review

Use of the Epidermal Growth Factor Receptor Inhibitors Gefitinib, Erlotinib, Afatinib, Dacomitinib, and Icotinib in the Treatment of Non-Small-Cell Lung Cancer: A Systematic Review

Prognostic role of a comprehensive geriatric assessment on the management of elderly patients with advanced non-small cell lung cancer (NSCLC): a pooled analysis of two prospective phase II trials by the GFPC Group

Molecular-targeted therapy for elderly patients with advanced non-small cell lung cancer

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