Treatment With Erlotinib May Benefit Patients With Advanced Lung Squamous Cell Carcinoma
According to the Merck Manual of Geriatrics , squamous cell carcinoma is the most common lung cancer among the elderly, accounting for 40% to 50% of lung cancers in patients 65 years of age and older. Erlotinib hydrochloride is a drug used to treat non-small cell cancer, including lung and pancreatic cancers. As a reversible tyrosine kinase inhibitor, it acts on the epidermal growth factor receptors, which are the cells that can lead to cancer when mutation occurs. In an article recently published in Cancer Chemotherapy and Pharmacology (2013;71:203-208), Chin-Lu Chiang, Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, and colleagues analyzed the efficacy of erlotinib in patients with advanced lung squamous cell carcinoma (LSQC).
The authors analyzed medical records and chest images of 55 patients with a diagnosis of advanced LSQC and treated with erlotinib. The median age of the patients (42 men, 13 women) was 71 years, with a range of 43 to 91 years. Nineteen patients never smoked, 19 had quit smoking, and 17 were smokers at the time of the evaluation. 70.9% of the patients had an score of 1 on the European Cooperative Oncology Group performance test, while 16.4% had a score of 2; 9.1% scored 0; and 3.6% scored higher than 2. Thirty-seven patients had measurable lesions, six of which had partial response while 13 had stable disease, yielding an overall response rate of 16.2% and disease control rate of 51.4%. The median progression-free survival (PFS) and overall survival (OS) for all patients were 2 months (95% confidence interval [CI], 1.5-2.4 months) and 10.4 months (95% CI, 0.6-20.2 months) respectively. Those with a good clinical response had significantly longer PFS and OS than those with a poor response (median PFS, 13 vs 1.6 months; median OS, 28.3 vs 4.9 months; both P values <.01). Patients who never smoked ( P=.077) had better clinical response and longer survival than those with a smoking history ( P=.086).
Other than standard platinum doublet chemotherapy, there are few treatment options for patients with advanced LSQC. No effective targeted therapy currently exists. Based on the above results, the authors concluded that erlotinib could provide some clinical benefit to patients with advanced LSQC.