differences in survival after docetaxel, erlotinib in EGFR depend

differences in survival after docetaxel, erlotinib in EGFR depend -

By Sarah Pritchard, medwireNews Reporter

The results of the trial indicate no DELTA significant difference in progression free (PF) or overall survival (OS) after treatment with docetaxel compared to erlotinib in lung cancer non-small cell (NSCLC) patients not selected for their growth factor receptor epidermal ( EGFR ) of the mutation status.

However, in the subgroup of patients whose tumors were positive for EGFR mutations, PFS and OS were not significantly longer in the erlotinib as docetaxel group, while in wild-type tumors, docetaxel was significantly superior to erlotinib in terms of PFS, the researchers observed in the Journal of Clinical Oncology .

Tomoya Kawaguchi (National Medical Center Hospital Organization Kinki-Chuo Chest, Osaka, Japan) and colleagues investigated the efficacy and tolerability of the EGFR tyrosine kinase inhibitor erlotinib versus erlotinib docetaxel using Lung Cancer Trial (DELTA) and docetaxel data. The study randomly assigned 301 patients with NSCLC who had undergone one or two previous chemotherapy regimens, to receive erlotinib 150 mg daily (n = 150) or docetaxel 60 mg / m ² all 3 weeks (n = 151).

After a median follow up of 8.9 months, the median PFS was not significantly longer in the docetaxel as erlotinib group, at 3.2 against 2.0 months. Conversely, the median OS was not significantly longer for those who received erlotinib against docetaxel at 14.8 against 12.2 months.

Patients whose tumors have undergone reaction analysis by polymerase chain reaction (n = 255), 199 were wild type EGFR disease, while 55 had mutations active. In the latter group, the median PFS and OS were longer for those who received erlotinib as docetaxel, 9.3 against 7.0 months and "not achieved" compared to 27.8 months, respectively; However, they were not significant differences, note Kawaguchi et al. PFS was significantly longer in docetaxel-treated patients with wild-type tumors compared to their counterparts in the erlotinib treated at 2.9 against 1.3 months.

The team used the common terminology criteria for adverse events to evaluate the safety results, and observed that erlotinib was more often associated with rash (92.7 % of patients), while docetaxel was associated more frequently fatigue (71.3%), nausea (50.0%) and hematological toxicities. In addition, much docetaxel patients erlotinib experienced grade 3 or 4 leucopenia, neutropenia and febrile neutropenia.

The researchers warn that their inability to detect a difference in PFS in the unselected patient population could be the result of a small sample size, and that caution should be used when comparing their results with other studies of PFS in this population

Nevertheless, they conclude :. "Given the active drugs available for chemotherapy poststudy could confer prolonged survival after progression, PFS can be a clinically relevant end point, and further research and discussion are needed."

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