Erlotinib in the treatment of advanced non‑small cell lung cancer – present experience and results in the Czech Republic

04/2018

MUDr. Helena Čoupková¹, Mgr. Renata Chloupková², Marek Konečný³, Mgr. Magda Bařinová³, prof. MUDr. Jana Skřičková, CSc.⁴, prof. MUDr. Miloš Pešek, CSc.⁵, prof. MUDr. Vítězslav Kolek, DrSc.⁶, doc. MUDr. František Salajka, CSc.⁷, doc. MUDr. Milada Zemanová, CSc.⁸, MUDr. Leona Koubková⁹, MUDr. Libor Havel¹⁰, MUDr. Kateřina Košatová¹¹

¹ Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno, ² Institut biostatistiky a analýz LF MU Brno, ³ Institut biostatistiky a analýz, s.r.o., Brno, ⁴ Klinika nemocí plicních a tuberkulózy LF MU a FN Brno, ⁵ Klinika nemocí plicních a tuberkulózy LF UK a FN Plzeň, ⁶ Klinika plicních nemocí a tuberkulózy LF UK a FN Olomouc, ⁷ Plicní klinika LF UK a FN Hradec Králové, ⁸ Onkologická klinika 1. LF UK a VFN Praha, ⁹ Pneumologická klinika 2. LF UK a FN v Motole, Praha, ¹⁰ Plicní klinika, Thomayerova nemocnice, Praha, ¹¹ Oddělení klinické onkologie, Nemocnice Na Homolce, Praha

SUMMARY

Erlotinib is an inhibitor of epidermal growth factor receptor (EGFR) tyrosine-kinase activity, a potent drug in non-small-cell lung cancer (NSCLC) treatment. In this paper, we report a population of patients suffering from advanced NSCLC who are being treated with erlotinib in the Czech Republic under the terms of the TULUNG drug registry (excluding the patients from the University Hospital of Ostrava). By October 2^nd 2017, 3763 patients were treated with erlotinib in this cohort. The overall response rate (ORR) in the entire group was 8,7 %, the disease control rate was 58,5 %. Survival data were updated on May 21^st 2018. Progression-free survival and overall survival were 3,1 months and 7,7 months, respectively. In our evaluation, we noticed a statistically significant difference both in overall survival (OS) and progression free survival (PFS) in patients grouped according to status of EGFR mutation, performance status, gender and smoking habits. Moreover, there was a statistically significant difference in PFS among patients grouped according to treatment line. Based on our results, skin toxicity appears to be a prognostic factor. The efficacy difference in squamous and non-squamous carcinomas was not statistically significant. From the 3763 patients included in the safety analysis, 1592 (42,3 %) experienced therapy-related adverse events, the most common was rash (35,3 %) and diarrhea (16,3 %). Serious adverse events (G3/4) were reported in 13,6 % patients, the most common was rash (9 %) and diarrhea (3 %). Our results confirm the efficacy and safety of the erlotinib therapy in the first and in the following lines of advanced NSCLC.

KEY WORDS

erlotinib, non-small-cell lung cancer, epidermal growth factor receptor mutation, efficacy, adverse events