A retrospective analysis of the outcome of patients who have received two prior chemotherapy regimens including platinum and docetaxel for recurrent non-small-cell lung cancer

Massarelli, Erminia; Varga, Andrea; Liu, D. D.; Lee, John; Wolf, Michael; Fandi, Abderrahim; Ochs, Judith; Chevalier, Thierry Le; Fossella, Frank V.; Herbst, Roy S.

doi:10.1016/s0169-5002(02)00308-2

Cited by 185 publications

(122 citation statements)

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“…Several cooperative groups have examined their databases to determine the prognostic factors for patients receiving systemic chemotherapy and to identify the most suitable lung cancer patients for treatment (O'Connell et al, 1986;Albain et al, 1991;Paesmans et al, 1995;Massarelli et al, 2003;Hoang et al, 2005). However, in general, these analyses included only patients receiving first-line chemotherapy and cytotoxic therapy (Massarelli et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

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Clinical Outcomes and Prognostic Factors Associated with the Response to Erlotinib in Non-Small-Cell Lung Cancer Patients with Unknown EGFR Mutational Status

Aydıner

Yıldız²,

Seyidova³

2013

Asian Pacific Journal of Cancer Prevention

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Background: The efficacy of erlotinib is controversial in patients with unknown EGFR mutational status. The aim of this study was to identify the clinicopathological factors that are predictive of erlotinob treatment outcomes for NSCLC patients with unknown EGFR mutational status. Materials and Methods: A retrospective analysis of 109 patients with advanced NSCLC who had previously failed at least one line of chemotherapy and received subsequent treatment with erlotinib (150 mg/day orally) was performed. A Cox proportional hazard model for univariate and multivariate analyses was used to identify the baseline clinical parameters correlating with treatment outcome, expressed in terms of hazard ratios (HRs) and 95% confidence intervals. Results: The median treatment duration was 15 weeks (range, 4-184). The disease control rate was 55%, including disease stability for ≥3 months for 40% of the patients. Median progression-free survival and median overall survival (OS) were 4.2 and 8.5 months, respectively. The Cox model indicated that an Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2 (HR 3.82; p<0.001), presence of intra-abdominal metastasis (HR 3.42; p=0.002), 2 or more prior chemotherapy regimens (HR 2.29; p=0.021), and weight loss >5% (HR 2.05; p=0.034) were independent adverse prognostic factors for OS in NSCLC patients treated with erlotinib. Conclusions: This study suggests that NSCLC patients should be enrolled in erlotinib treatment after a first round of unsuccessful chemotherapy to improve treatment success, during which they should be monitored for intra-abdominal metastasis and weight loss.

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Section: Discussionmentioning

confidence: 99%

“…However, in general, these analyses included only patients receiving first-line chemotherapy and cytotoxic therapy (Massarelli et al, 2003). Few reports have studied the prognostic factors for patients with NSCLC receiving second-or even third-line targeted therapies (Massarelli et al, 2003;Hsu et al, 2012).…”

Section: Discussionmentioning

confidence: 99%

Clinical Outcomes and Prognostic Factors Associated with the Response to Erlotinib in Non-Small-Cell Lung Cancer Patients with Unknown EGFR Mutational Status

Aydıner

Yıldız²,

Seyidova³

2013

Asian Pacific Journal of Cancer Prevention

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“…A retrospective analysis has shown that improvement in survival beyond second-line treatment using chemotherapy is only modest [28]. In the case of erlotinib, benefits in response and survival are similar for those undergoing second-or subsequent-line treatment (median survival times of 6.3 months and 6.8 months for second-and third-line treatments, respectively) [22], so it seems rational to consider second-line treatment with docetaxel or pemetrexed and third-line treatment with erlotinib.…”

Section: Thementioning

confidence: 99%

Clinical Evidence for Second- and Third-Line Treatment Options in Advanced Non-Small Cell Lung Cancer

Marinis

Grossi²

2008

The Oncologist

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In the U.S. and Europe, the current options for the second-and third-line treatment of advanced non-small cell lung cancer (NSCLC) are cytotoxic drugs and targeted agents. Docetaxel was the first drug approved for second-line treatment after two phase III trials demonstrated its superiority over best supportive care (BSC) alone and single-agent chemotherapy. Pemetrexed was also registered for use as second-line therapy after it was demonstrated to have activity comparable with, and a more favorable toxicity profile than, docetaxel. Erlotinib, an epidermal growth factor receptor inhibitor, is the only biological agent to have been approved in the U.S. and Europe for lung cancer treatment after a study showed its superiority over BSC in recurrent (second-/third-line) NSCLC patients. This review focuses on these drugs, dealing with the results supporting the choice among docetaxel, pemetrexed, and erlotinib in second-and/or third-line treatment. The Oncologist 2008;13(suppl 1):14-20

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“…Furthermore, treatment options are limited for patients who relapse after 1st-or 2nd-line chemotherapy. A retrospective analysis of patients with advanced NSCLC receiving 3rd-and 4th-line chemotherapy showed that response rates decreased with each successive chemotherapy regimen, as follows: 1st line, 20.9%; 2nd line, 16.3%; 3rd line, 2.3%; and 4th line, 0% (4). There is therefore an urgent need for effective and well-tolerated therapies for these patients.…”

Section: Introductionmentioning

confidence: 99%

Gefitinib (ZD1839) Monotherapy as a Salvage Regimen for Previously Treated Advanced Non-Small Cell Lung Cancer

Park

Kim

et al. 2004

Clinical Cancer Research

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Purpose: A worldwide compassionate-use program has enabled >42,000 patients with advanced non-small cell lung cancer (NSCLC) to receive gefitinib treatment. Here we report the outcome of gefitinib therapy in patients who enrolled in the "Iressa" Expanded Access Program at the Samsung Medical Center.Experimental Design: Patients with advanced or metastatic NSCLC who had progressed after prior systemic chemotherapy and for whom no other treatment option was available were eligible to receive gefitinib treatment as part of the Expanded Access Program. A post hoc assessment of potential prognostic factors for response and survival was performed by multivariate analysis.Results: All 111 evaluable patients had stage IV disease; most patients had a baseline performance status of 2 [n ‫؍‬ 52 (47%)] or 3 [n ‫؍‬ 18 (16%)] and had received >2 prior chemotherapy regimens (56%). The objective response rate was 26%, the disease control rate (measured over >8 weeks) was 40%, and the 1-year survival rate was 44%. Adenocarcinoma histology was associated with better response and disease control rates, and a performance status of 0 -2 was also associated with a better disease control rate. Both of these factors, as well as female gender, were significantly associated with longer survival. Gefitinib was well tolerated; the most common adverse event was grade 1 skin rash.Conclusions: Gefitinib demonstrated significant antitumor activity and a favorable tolerability profile in this series of NSCLC patients with poor prognosis.

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A retrospective analysis of the outcome of patients who have received two prior chemotherapy regimens including platinum and docetaxel for recurrent non-small-cell lung cancer

Cited by 185 publications

References 11 publications

Clinical Outcomes and Prognostic Factors Associated with the Response to Erlotinib in Non-Small-Cell Lung Cancer Patients with Unknown EGFR Mutational Status

Clinical Outcomes and Prognostic Factors Associated with the Response to Erlotinib in Non-Small-Cell Lung Cancer Patients with Unknown EGFR Mutational Status

Clinical Evidence for Second- and Third-Line Treatment Options in Advanced Non-Small Cell Lung Cancer

Gefitinib (ZD1839) Monotherapy as a Salvage Regimen for Previously Treated Advanced Non-Small Cell Lung Cancer

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