Second- and third-line treatment of patients with non-small-cell lung cancer with erlotinib in the community setting: retrospective study of patient healthcare utilization and symptom burden.

Introduction: The purpose of this study was to describe treatment use patterns and outcomes with single-agent erlotinib among patients with advanced non-small-cell lung cancer (NSCLC) in the community oncology setting.

Patients And Methods: Retrospective chart review identified patients treated with single-agent erlotinib as either second- or third-line therapy from 4 community oncology clinics. Medical records were extracted for medical outcomes and resource utilization. Patients reported outcome measures of symptom burden and functioning.

Results: A total of 45 patients with stage IIIB/IV disease in second- (n = 27) or third-line (n = 18) therapy were 44% female and 84% white (16% black), with mean age of 66.7 years (SD, 9.2). Over 93% of the patients had previous platinum-based chemotherapy. Patients were treated with erlotinib for an average of 24 weeks. Dose reductions (24%) and treatment delays (29%) were due to skin reactions, diarrhea, and fatigue. The most common reasons for stopping erlotinib therapy were disease progression (53%), death (22%), and toxicities (11%). Patients' physical functioning improved during the first 3 months of erlotinib therapy. Hospitalizations (22%) were not due to erlotinib complications, and unplanned medical visits to the clinics were rare.

Conclusion: Data from this community sample were generally in agreement with the major clinical trial of erlotinib. Erlotinib is well tolerated by second- and third-line patients with advanced NSCLC in the community setting.