Efficacy of erlotinib and its effects on the quality of life of older patients with epidermal growth factor receptor‐mutant non‐small cell lung cancer: A prospective, multicenter, dose‐modification study

AIM: Gefitinib and erlotinib are efficacious and safe for older patients with epidermal growth factor receptor‐mutant non‐small cell lung cancer. However, prolonged use of epidermal growth factor receptor‐tyrosine kinase inhibitors in older patients is difficult, owing to potential adverse events. Hence, dose reduction or treatment discontinuation is often required. We investigated the efficacy of low‐dose first‐line erlotinib and its effects on the quality of life of older patients with lung cancer. METHODS: A prospective, multicenter, phase II clinical trial was carried out in patients aged ≥75 years with epidermal growth factor receptor‐mutant non‐small cell lung cancer. Initially, 100 mg/day erlotinib was administered orally; if well tolerated, it was increased to 150 mg/day. The primary end‐point was progression‐free survival, and secondary end‐points were the response rate, overall survival and change in quality of life (“Care Notebook” questionnaire). RESULTS: The median progression‐free survival was 17.8 months, response rate was 63.6% and median overall survival was 27.8 months. The change in the quality of life after 6 weeks was assessed in 72.7% of the patients. Fatigue, pain, anxiety and deterioration in daily activities were found in at least 40% of the patients. Despite the therapeutic effect of 100 mg/day erlotinib, many patients required dose reduction, and in some, the quality of life could not be maintained. CONCLUSIONS: Many older patients with epidermal growth factor receptor‐mutant non‐small cell lung cancer might require treatment dose reduction. Further studies are required to develop individualized treatments for older patients with lung cancer. Geriatr Gerontol Int 2021; 21: 881–886.