PURPOSE: Erlotinib is a tyrosine kinase inhibitor used as second and third-line therapy in patients with metastatic NSCLC (mNSCLC). We report our experience with erlotinib use in a minority patient population.
METHODS: Data from 33 patients with mNSCLC treated at Cook County Hospital, Chicago, Illinois over a 2 year period were collected. Demographics, pathology of primary disease, indication for erlotinib, tolerability and response were analyzed.
RESULTS: 33 patients (average age 60.1 yrs, range 31-73 yrs) were identified and analyzed as a retrospective cohort. 54.5% were African American (AA), 3% Caucasian, 18.2% Hispanic, 21.2% Eastern European, and 3% Asian. 78.8% of patients were smokers. 21.2% were non-smokers, who were all non-AA. 87.9% of pts had failed a previous platinum-based regimen. Erlotinib was used as first line treatment in 12.1%, due to refusal of chemotherapy or poor performance status. 21 (63.6%) pts had erlotinib-related toxicities including skin rash, diarrhea and nausea. Erlotinib dose was reduced in 3 pts and discontinued in 3 pts due to toxicities. AA pts were significantly older than non-AA pts (63.4 vs 51.4 p=0.04). Average duration of response (DOR) was 3.5 months (m); Range 2 weeks (wks) to 20m [AA 2.36m; Range 2wks to 7m, non-AA 4.87m; Range 2wks to 20m]. Non-AA pts trended towards a longer DOR than AA pts (4.87m vs 2.36m, p=0.08). DOR was comparable in AA male and AA female pts (2.29m vs 2.55m) and slightly improved in non-AA females than non-AA males (5.3m vs 4m).
CONCLUSION: In this primarily minority-based cohort AA pts were generally older with a shorter DOR than the non-AA pts. This could be due to the non-AA cohort having a higher percent of non-smokers and probably more responsive to biologic agents. Overall erlotinib was well tolerated. Since the number of patients is small, definitive conclusions in either cohort cannot be made. Further investigation in minority patients is warranted.
CLINICAL IMPLICATIONS: Erlotinib could have favorable response in non-smoker, non-AA pts with mNSCLC as a second or third-line therapy.
DISCLOSURE: Sunita Nathan, No Financial Disclosure Information; No Product/Research Disclosure Information