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Effectiveness of erlotinib treatment in advanced KRAS mutation-negative lung adenocarcinoma patients: Results of a multicenter observational cohort study (MOTIVATE).
- Source :
-
Lung cancer (Amsterdam, Netherlands) [Lung Cancer] 2014 Oct; Vol. 86 (1), pp. 54-8. Date of Electronic Publication: 2014 Jul 27. - Publication Year :
- 2014
-
Abstract
- Objectives: Erlotinib is an epidermal growth factor receptor tyrosine-kinase inhibitor (EGFR-TKI), used for the treatment of non-small cell lung cancer. As the clinical significance of KRAS mutational status has not yet been clearly determined in this setting, our aim was to investigate the efficacy of erlotinib in advanced KRAS mutation-negative lung adenocarcinoma patients.<br />Materials and Methods: MOTIVATE is an open-label, multicenter, observational trial with Tarceva(®) (erlotinib) monotherapy. Enrolled patients with advanced (stage IIIB/IV) KRAS wild type (WT) lung adenocarcinoma refractory to one or two courses of prior chemotherapy were treated with erlotinib at 150mg/day. The primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS) and best tumor response rate (RR).<br />Results and Conclusion: In total, 327 patients were included. Median PFS and OS were 3.3 and 14.4 months, respectively. Three patients (1.2%) had complete response, 51 patients (20.2%) had partial response and 123 patients (48.8%) had SD. Significantly longer median PFS and OS were observed in Eastern Oncology Cooperative Group Performance Status (ECOG PS) 0-1 patients, as compared to ECOG PS 2-3 patients. The longest median OS (20.5 months) was found in patients with ECOG PS 0-1 who received erlotinib as a second-line therapy. There was no difference in median OS in cohorts stratified to disease stage and smoking status. Female patients had both longer median PFS and OS. Disease control rate was 70.2%. Our results suggest that erlotinib represents a valid treatment option for patients with KRAS WT lung adenocarcinoma and, moreover, that KRAS mutation analysis could help to identify clinically relevant subgroups of NSCLC patients that may benefit from EGFR-TKI therapy.<br /> (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Adenocarcinoma mortality
Adenocarcinoma pathology
Adenocarcinoma of Lung
Adult
Aged
Antineoplastic Agents administration & dosage
Antineoplastic Agents adverse effects
Cohort Studies
Erlotinib Hydrochloride
Female
Humans
Lung Neoplasms mortality
Lung Neoplasms pathology
Male
Middle Aged
Neoplasm Staging
Protein Kinase Inhibitors administration & dosage
Protein Kinase Inhibitors adverse effects
Quinazolines administration & dosage
Quinazolines adverse effects
Risk Factors
Treatment Outcome
Adenocarcinoma drug therapy
Adenocarcinoma genetics
Antineoplastic Agents therapeutic use
Genes, ras
Lung Neoplasms drug therapy
Lung Neoplasms genetics
Mutation
Protein Kinase Inhibitors therapeutic use
Quinazolines therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1872-8332
- Volume :
- 86
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Lung cancer (Amsterdam, Netherlands)
- Publication Type :
- Academic Journal
- Accession number :
- 25129367
- Full Text :
- https://doi.org/10.1016/j.lungcan.2014.07.011