Erlotinib may improve life quality in advanced NSCLC
medwireNews: Treating advanced epidermal growth factor receptor (EGFR)-mutation-positive non-small-cell lung cancer (NSCLC) with erlotinib appears to improve quality of life (QoL) compared with standard first-line chemotherapy, study results indicate.
The significant improvement in patients' QoL provided by erlotinib may be "due to the more favourable tolerability profile of erlotinib versus chemotherapy," say Caicun Zhou (Shanghai Pulmonary Hospital, China) and team.
QoL was analyzed in 128 Chinese patients with EGFR-mutation-positive stage IIIB or IV NSCLC. Those treated with erlotinib (n=74) showed greater improvement in three measures of QoL than those treated with gemcitabine-carboplatin (n=54), and the size of improvement was "clinically relevant" for about three-quarters of the patients, say the researchers.
The Functional Assessment of Cancer Therapy-Lung (FACT-L) questionnaire, which incorporates the Trial Outcome Index (TOI) and the Lung Cancer Subscale (LCS), was used to assess QoL. Patients were asked to complete the questionnaire at baseline and then every 6 weeks; to be included in the analysis, they must have completed it at baseline and then at least at one other timepoint.
The FACT-L questionnaire specifically assessed the physical, social, emotional, and functional well-being of patients; the LCS assessed the seven main lung cancer symptoms: dyspnea, chest pain, cough, breathing difficulty, anorexia, weight loss and cognition; and the 21-item TOI assessed patient outcomes for the LCS, as well as functional and physical well-being.
(PFS), defined as time from randomization to or death from any cause, was also determined. Also, patients treated with erlotinib were found to have a significantly longer progression-free survival (time from randomization to first confirmed disease progression) than those treated with standard chemotherapy, at a median of 13.7 versus 4.6 months.
Writing in the Annals of Oncology, Zhou and co-authors say that EGFR mutations occur more frequently in NSCLC patients of Asian origin than in non-Asian patients. They therefore surmise that "a greater proportion of Asian patients are likely to gain clinical benefit from treatments such as erlotinib."
The authors conclude that because QoL provides an assessment of the balance between efficacy and tolerability of a drug, it should be considered by doctors as a clinical factor of "vital importance" among patients with metastatic NSCLC.
medwireNews (www.medwirenews.com) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2013
By Lauretta Ihonor, medwireNews Reporter