Impact of Neoadjuvant Erlotinib on Radical Resection Rate in Patients With NSCLC
Posted: Tuesday, October 16, 2018
When administered as neoadjuvant therapy, erlotinib may improve the radical resection rate in patients with non–small cell lung cancer (NSCLC), according to a study published in The Oncologist. Baohui Han, MD, PhD, of the Shanghai Chest Hospital, China, and colleagues sought to determine the effect of this treatment on the operability and survival of patients with stage IIIA to N2, EGFR mutation–positive NSCLC.
In the phase II study, 19 patients received 150 mg of neoadjuvant erlotinib daily for 56 days. Following this therapy, the radical resection rate was 68.4% (13 of 19 patients), with 14 patients undergoing surgery after treatment. The rate of pathologic downstaging was 21.1% (4 of 19 patients). Overall, 36.8% of patients (7 of 19) experienced adverse events. The most common adverse event among affected participants was rash (26.3%).
Median progression-free survival for all patients in this study was 11.2 months, with median overall survival reaching 51.6 months. Among patients undergoing surgery, median disease-free survival was 10.3 months. A total of 89.5% of participants (17 of 19) experienced disease control, and the objective response rate was 42.1%.
In addition, researchers noted that “effects of TP53 mutation on prognosis were evaluated in eight patients with adequate tissue samples. Next‐generation sequencing revealed that most patients had a TP53 gene mutation (7 of 8) in addition to an EGFR mutation. No TP53 mutation, or very low abundance, was associated with longer [progression-free survival] (36 and 38 months, respectively), whereas high abundance was associated with short [progression-free survival] (8 months).”
