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Are EGFR tyrosine kinase inhibitors effective in elderly patients with EGFR-mutated non-small cell lung cancer?

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Abstract

EGFR tyrosine kinase inhibitors (TKIs) such as erlotinib, gefitinib, and afatinib changed dramatically the history of metastatic non-small cell lung cancer (NSCLC) harbouring EGFR mutations. However, not enough data are available on the efficacy of these targeted drugs in elderly patients. The aim of this study is to analyse the available clinical data evaluating the efficacy of anti-EGFR therapies in elderly patients with advanced NSCLC carrying EGFR mutations. A literature-based meta-analysis of the results of randomized clinical trials was undertaken. Relevant publications from PubMed, the Cochrane Library, and abstracts from American Society of Clinical Oncology meetings were searched. Progression-free survival (PFS), as a measure of the efficacy of treatment, was the primary outcome investigated. The pooled analysis revealed an overall significant improvement in PFS (HR = 0.44, 95% CI 0.28–0.69; p = 0.0004) with the use of EGFR TKIs in EGFR-mutated NSCLC. The data stratification per age subgroups showed that EGFR TKIs were more effective in prolonging PFS in elderly patients, with HR 0.39 (p = 0.008), in comparison with young patients (HR = 0.48; p = 0.04). The results of this study suggest that EGFR TKIs have a significant effect in slowing down diseases progression in elderly patients with advanced NSCLC, therefore representing a valid therapeutic option in this age group.

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Acknowledgements

We thank Dr. Paola Corona for her careful linguistic review of the manuscript.

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Authors and Affiliations

  1. Department of Molecular and Translational Medicine, University of Brescia, 25123, Brescia, Italy

    Giandomenico Roviello

  2. Unit of Molecular Therapy and Pharmacogenomic, ASST Cremona, Viale Concordia 1, 26100, Cremona, Italy

    Giandomenico Roviello, Laura Zanotti, Maria Rosa Cappelletti, Angela Gobbi, Martina Dester & Daniele Generali

  3. Unit of General Medicine, Azienda Ospedaliera “C. Poma” Presidio ospedaliero di Pieve di Coriano, Mantua, Italy

    Giovanni Paganini

  4. Unit of Radiotherapy, Department of Medical, Surgical Sciences and Neurosciences, Siena University, Viale Bracci 11, 53100, Siena, Italy

    Chiara Pacifico

  5. Department of Medical, Surgery and Health Sciences, University of Trieste, Piazza Ospitale 1, 34129, Trieste, Italy

    Daniele Generali

  6. Oncopathology Research Center, Iran University of Medical Sciences, Tehran, Iran

    Raheleh Roudi

  7. Medical Oncology Unit, Department of Oncology, San Donato Hospital, Via Nenni 20, 52100, Arezzo, Italy

    Giandomenico Roviello

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  1. Giandomenico Roviello
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  2. Laura Zanotti
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  3. Maria Rosa Cappelletti
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  4. Angela Gobbi
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  8. Daniele Generali
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Correspondence to Giandomenico Roviello.

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Roviello, G., Zanotti, L., Cappelletti, M.R. et al. Are EGFR tyrosine kinase inhibitors effective in elderly patients with EGFR-mutated non-small cell lung cancer?. Clin Exp Med 18, 15–20 (2018). https://doi.org/10.1007/s10238-017-0460-7

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  • DOI: https://doi.org/10.1007/s10238-017-0460-7

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