Research Papers: Gerotarget (Focus on Aging):
Octogenarians with EGFR-mutated non-small cell lung cancer treated by tyrosine-kinase inhibitor: a multicentric real-world study assessing tolerance and efficacy (OCTOMUT study)
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Abstract
Romain Corre1,12, Radj Gervais2, Florian Guisier3, Louis Tassy4, Florent Vinas5, Régine Lamy6, Gislaine Fraboulet7, Laurent Greillier8, Helene Doubre9, Renaud Descourt10, Christos Chouaid5 and Jean-Bernard Auliac11
1 Department of Pneumology, CHU Pontchaillou, Rennes, France
2 Pneumo-Oncology Department, Centre Francois Baclesse, Caen, France
3 Pneumology Department, CHU Hôpitaux de Rouen-Charles Nicolle, Rouen, France
4 Oncology Department, Institut Paoli-Calmette, Marseille, France
5 Pneumology Department, CH Intercommunal de Créteil, Créteil, France
6 Oncology Department, CH Sud-Bretagne, Lorient, France
7 Pneumology Department, Hôpital René-Dubos, Pontoise, France
8 Pneumo-Oncology Department, Hôpital Sainte-Marguerite, Assistance Publique-Hôpitaux de Marseille, Marseille, France
9 Pneumology Department, Hôpital Foch, Suresnes, France
10 Cancerology Institute, CHU Brest, Brest, France
11 Pneumology Department, CH François Quesnay, Mantes La Jolie, France
12 UMR INSERM U1242-COSS, Rennes University, Rennes, France
Correspondence to:
Romain Corre, email:
Keywords: targeted therapies; tyrosine-kinase inhibitors; non-small cell lung cancer; EGFR; elderly; Gerotarget
Received: September 22, 2017 Accepted: November 13, 2017 Published: January 02, 2018
Abstract
Objective. To assess efficacy and tolerance of EGFR tyrosine-kinase inhibitors (TKIs) for advanced EGFR-mutated non-small cell lung cancer (NSCLC) in octogenarians.
Patients and methods. Patients aged 80 years or older with EGFR-mutated NSCLC treated by EGFR TKI between January 2011 and March 2015 whatever the line of treatment were retrospectively selected.
Results. 20 centers retrospectively included 114 patients (women, 77.2%; Caucasians, 98.3%; mean age, 83.9 years). A performance status of 0–1 or 2–3 at diagnosis was reported for 71.6% and 28.4% of patients, respectively. Overall, 95.6% of patients had adenocarcinomas and histological stage at diagnosis was stage IV for 79.8% of patients. EGFR mutations were identified mainly on exon 19 (46.5%) and exon 21 (40.4%). A geriatric assessment was performed in 35.1% of patients. TKI treatment was administered to 97.3% of patients as first or second line of treatment. Overall response rate and disease control rate were 63.3% (69/109) and 78.9% (86/109), respectively. Median progression-free survival was 11.9 months (95% confidence interval [CI], 8.6–14.7) and median overall survival was 20.9 months (95% CI, 14.3–27.1). After progression, 36/95 (37.9%) patients received a new line of chemotherapy. Main toxicities were cutaneous for 66.7% of patients (grade 3–4, 10%), diarrhea for 56.0% (grade 3–4, 15%; grade 5, 2%) and others for 25.7% (grade 3–4, 41%).
Conclusions. Octogenarians with EGFR-mutated NSCLC treated by EGFR TKI had clinical outcomes and toxicity profile comparable to younger patients. Geriatric assessment appeared to be underused in this population.
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