Overview of advanced non-small-cell lung cancer treatment in Mexico

BACKGROUND: Lung cancer is the leading cause of cancer-related deaths among males and the second among females. The importance of lung cancer is a major public health problem and there is a need to find effective therapies for its management. Erlotinib has been approved to treat non-small-cell lung cancer. The author's experience in the use of erlonitib in lung cancer patients in Mexico City is described below. METHODS: The series includes 17 consecutive patients treated for advanced lung cancer. All patients had measurable disease. Treatment continues until disease progression or significant toxicity occurs. Among patients, adenocarcinoma was the most common tumor histology, followed by bronchioloalveolar tumor, and epidermoid carcinoma. Nine patients received erlotinib as first-line therapy. Of the remaining 8 patients, 4 had undergone surgery, 2 had received chemotherapy, and 2 had received combined chemotherapy and radiotherapy. RESULTS: Four patients achieved complete remission of the disease, and 7 showed partial response. Five subjects experienced disease progression, and one patient showed stable disease. The most significant cases were two non-smokers women with bronchioloalveolar cancer, who remain in complete remission after erlotinib treatment. A non-smoker male patient with adenocarcinoma histology, who rejected chemotherapy and radiotherapy, it remains in complete remission after 15 months of treatment. A man with epidermoid carcinoma, with previous surgery and treated with chemotherapy and radiotherapy, with tumor recurrence, showed a complete 15-month remission with erlotinib. It was observed clinical response due to treatment with erlotinib despite the tumor histopathology, but therapeutic response was better in patients without smoking history. The most common adverse events associated with erlotinib therapy were dermatologic. After discontinuing treatment for a short period, patients were again given erlotinib without experiencing toxic effects. Hepatotoxic side effects associated to erlotinib were mild and reversible. CONCLUSION: Data from this small series of patients support findings reported in the literature. Female non-smokers showed the best therapeutic response to erlotinib treatment. Erlotinib could be considered as a first-line therapeutic option in elderly patients with locally advanced or metastatic lung cancer, or in women with adenocarcinoma.