Randomized Phase II Trial of Erlotinib or Standard Chemotherapy in Patients With Advanced Non–Small-Cell Lung Cancer and a Performance Status of 2

Lilenbaum, Rogério; Axelrod, Rita; Thomas, Sachdev; Dowlati, Afshin; Seigel, Leonard; Albert, Donald G.; Witt, Karsten; Botkin, D.

doi:10.1200/jco.2007.13.2720

Cited by 161 publications

(128 citation statements)

References 9 publications

(2 reference statements)

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“…Billingham and Cullen found superior palliation among PS 2 patients in comparison to PS 0/1 [12] in two randomized trials using mitomycin, ifosfamide and cisplatin in the treatment of unresectable NSCLC [25]. Furthermore, in a recent randomized phase II study on first line erlotinib versus standard chemotherapy of PS 2 advanced NSCLC patients, HRQOL tended to improve rather than worsen in both treatment arms [26]. In fact, the authors concluded that unselected advanced NSCLC PS 2 patients are best treated with combination chemotherapy in first-line.…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy and quality of life in NSCLC PS 2 patients

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Chemotherapy and quality of life in NSCLC PS 2 patients

et al. 2009

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“…In one trial, pfs was longer in the egfr inhibitor group: 4.57 months for erlotinib versus 2.53 months for vinorelbine (hr: 0.6444; 95% ci: 0.4325 to 0.9601; p = 0.0308) 21 . In five trials, pfs was longer in the chemotherapy group 13,15,17,19,20 . Several of the trials found that pfs significantly favoured chemotherapy 13,15,19 .…”

Section: First-line Treatmentmentioning

confidence: 99%

“…In five trials, pfs was longer in the chemotherapy group 13,15,17,19,20 . Several of the trials found that pfs significantly favoured chemotherapy 13,15,19 . One trial examined time to progression and found that it was longer with chemotherapy, but not significantly so 20 .…”

Section: First-line Treatmentmentioning

confidence: 99%

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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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“…This study showed a lower PFS and OS compared with chemotherapy. 179 A randomized trial comparing gefitinib versus placebo in patients not candidates for chemotherapy with PS 2-3 revealed no advantage in OS and PFS for patients receiving gefitinib. Only in the subgroup with FISH-positive EGFR was there a statistically significant advantage in PFS.…”

Section: Systemic Treatment In Poor Performance Status Patientsmentioning

confidence: 99%

Extending Survival of Stage IV Non-Small Cell Lung Cancer

Carnio

Novello²,

Mele³

et al. 2014

Seminars in Oncology

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Extending survival of stage IV non-small cell lung cancer. Carnio S, Novello S, Mele T, Levra MG, Scagliotti GV. La versione definitiva è disponibile alla URL: http://www.sciencedirect.com/science/article/pii/S0093775413002236 Extending Survival of Stage IV Non-Small Cell Lung CancerCarnio S, Novello S, Mele T, Levra MG, Scagliotti GV.Most of patients with newly diagnosed non-small cell lung cancer (NSCLC) present with locally advanced or metastatic disease. In this setting the goal of treatment is to prolong survival and to control disease-and treatment-related symptoms. Currently systemic cytotoxic chemotherapy remains the first-line treatment for most patients with stage IV NSCLC, but preferred treatments are now defined by histology and based on the presence of specific molecular abnormalities. In firstline the combination of platinum plus pemetrexed with or without bevacizumab is a reasonable choice in patients with non-squamous NSCLC. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) as first-line therapy are the recommended for patients with EGFRsensitizing mutations. A small-molecule TKI of anaplastic lymphoma kinase (ALK), crizotinib, showed pronounced clinical activity in the treatment of patients with NSCLC positive for EML4-ALK and it has rapidly entered into daily clinical practice. Currently no agents are specifically approved for the treatment of squamous cell carcinoma of the lung. Second-line treatments include docetaxel, pemetrexed, or erlotinib as single agents. There is a growing evidence that cytotoxics are better than EGFR-TKIs in EGFR wild-type patients. In the setting of the third line, the only approved agent is erlotinib. In elderly patients with good performance status (PS), doublet chemotherapy including platinum should not be excluded, especially for those patients 70-75 years of age without comorbidities. The better selection of patients, the identification of specific predictive biomarkers, a reasonable sequencing of all active and available treatments, including targeted therapies and cytotoxic, may significantly contribute to extend the natural history of stage IV NSCLC.Lung cancer remains a relevant health care problem and in the near future will account for almost 30% of all cancer-related deaths. Non-small cell lung cancer (NSCLC) represents more than 80% of all lung cancer cases. The majority of patients with lung cancer are diagnosed at baseline with locally advanced or metastatic disease. The increase in life expectancy with the associated cumulative increase in the risk of cancer has led to an increased incidence of this disease in the elderly population. Overall the incidence and death rates for lung cancer are decreasing for both men and women 1 ; however, the 5-year survival in stage IV NSCLC remains as low as 1%. 2According to the current World Health Organization (WHO) classification for lung tumors, NSCLC includes many histological subtypes, but for therapeutic purposes it can be broadly categorized as squamous and non-squamous. This non-canon...

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Randomized Phase II Trial of Erlotinib or Standard Chemotherapy in Patients With Advanced Non–Small-Cell Lung Cancer and a Performance Status of 2

Abstract: Unselected patients with advanced NSCLC and PS 2 are best treated with combination chemotherapy as first-line therapy. Erlotinib may be considered in patients selected by clinical or molecular markers.

Cited by 161 publications

References 9 publications

Chemotherapy and quality of life in NSCLC PS 2 patients

Chemotherapy and quality of life in NSCLC PS 2 patients

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

Extending Survival of Stage IV Non-Small Cell Lung Cancer

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