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SELECT Trial: Adjuvant Erlotinib in Resected EGFR-Mutant NSCLC

By: Nahae Kim
Posted: Tuesday, January 8, 2019

According to the findings of the phase II SELECT trial, published in the Journal of Clinical Oncology, adjuvant erlotinib appears to be of benefit in patients with EGFR-mutant non–small cell lung cancer (NSCLC). Most patients treated with the EGFR tyrosine kinase inhibitor (69%) were able to complete up to 2 years of therapy, with improved disease-free survival rates compared with historic genotype-matched controls.

According to Nathan A. Pennell, MD, PhD, of the Cleveland Clinic Taussig Cancer Institute, and colleagues, “Recurrences were rare for patients receiving adjuvant erlotinib, and patients rechallenged with erlotinib after recurrence experienced durable benefit.” 

Between January 2008 and May 2012, a total of 100 patients with resected stage IA to IIIA disease who had completed standard adjuvant chemotherapy with or without radiotherapy were enrolled in the study. They were treated daily with 150 mg of erlotinib for 2 years.

With a median follow-up of 5.2 years, disease-free survival was 88% at 2 years and 56% at 5 years; the overall survival rate was 86%. Recurrence was evident in four patients.

As for toxicity, no grade 4 or 5 adverse events were reported, and one case of grade 2 pulmonary fibrosis was noted. Other toxicities typical of erlotinib were observed; they included rash, diarrhea, dry skin, fatigue, nausea/vomiting, nail changes, pruritus, stomatitis, and transaminitis.

Overall, 40% of patients required a dose reduction to 100 mg/d, and 16% required a dose reduction to 50 mg/d. A total of 11 patients discontinued erlotinib within the first month due to treatment intolerance.

Disclosure: The study authors’ disclosure information may be found at ascopubs.org.



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