Michael P Chu1, Sunita Ghosh1, Carole R Chambers2, Naveen Basappa1, Charles A Butts1, Quincy Chu1, David Fenton3, Anil A Joy1, Randeep Sangha1, Michael Smylie1, Michael B Sawyer4. 1. Department of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada. 2. Department of Pharmacy, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada. 3. Department of Medical Oncology, BC Cancer Agency, Vancouver Island Centre, Victoria, British Columbia, Canada. 4. Department of Medical Oncology, Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada. Electronic address: michael.sawyer@albertahealthservices.ca.
Abstract
BACKGROUND: Erlotinib is a key therapy for advanced NSCLC. Concurrent AS therapy with TKIs might reduce TKI plasma levels. Because of gastroesophageal reflux disease prevalence, this retrospective analysis was undertaken to determine if coadministering erlotinib with AS therapy affected NSCLC outcomes. PATIENTS AND METHODS: Records of advanced NSCLC patients who received erlotinib from 2007 to 2012 at a large, centralized, cancer institution were retrospectively reviewed. Pertinent demographic data were collected and concomitant AS treatment was defined as AS prescription dates overlapping with ≥ 20% of erlotinib treatment duration. Records of patients who received erlotinib for ≥ 1 week were analyzed for progression-free survival (PFS) and overall survival (OS). RESULTS: Stage IIIB/IV NSCLC patients (n = 544) were identified and 507 had adequate data for review. The median age was 64 years and 272 were female. Adenocarcinoma (n = 318; 64%) and squamous (n = 106; 21%) were predominant subtypes; 124 patients received concomitant AS therapy. In this unselected population, median PFS and OS in AS versus no AS groups were 1.4 versus 2.3 months (P < .001) and 12.9 versus 16.8 months (P = .003), respectively. Factoring sex, subtype, and performance status in multivariate Cox proportional hazards ratios for PFS and OS between AS and no AS groups were 1.83 (95% confidence interval [CI], 1.48-2.25) and 1.37 (95% CI, 1.11-1.69), respectively. CONCLUSION: This large population-based study suggests erlotinib efficacy might be linked with gastric pH and OS could be adversely affected. To our knowledge, this is the first study demonstrating a possible negative clinical effect of coadministration of erlotinib with AS therapy. Further prospective investigation is warranted.
BACKGROUND:Erlotinib is a key therapy for advanced NSCLC. Concurrent AS therapy with TKIs might reduce TKI plasma levels. Because of gastroesophageal reflux disease prevalence, this retrospective analysis was undertaken to determine if coadministering erlotinib with AS therapy affected NSCLC outcomes. PATIENTS AND METHODS: Records of advanced NSCLCpatients who received erlotinib from 2007 to 2012 at a large, centralized, cancer institution were retrospectively reviewed. Pertinent demographic data were collected and concomitant AS treatment was defined asAS prescription dates overlapping with ≥ 20% of erlotinib treatment duration. Records of patients who received erlotinib for ≥ 1 week were analyzed for progression-free survival (PFS) and overall survival (OS). RESULTS: Stage IIIB/IV NSCLCpatients (n = 544) were identified and 507 had adequate data for review. The median age was 64 years and 272 were female. Adenocarcinoma (n = 318; 64%) and squamous (n = 106; 21%) were predominant subtypes; 124 patients received concomitant AS therapy. In this unselected population, median PFS and OS in AS versus no AS groups were 1.4 versus 2.3 months (P < .001) and 12.9 versus 16.8 months (P = .003), respectively. Factoring sex, subtype, and performance status in multivariate Cox proportional hazards ratios for PFS and OS between AS and no AS groups were 1.83 (95% confidence interval [CI], 1.48-2.25) and 1.37 (95% CI, 1.11-1.69), respectively. CONCLUSION: This large population-based study suggests erlotinib efficacy might be linked with gastric pH and OS could be adversely affected. To our knowledge, this is the first study demonstrating a possible negative clinical effect of coadministration of erlotinib with AS therapy. Further prospective investigation is warranted.
Authors: Elizabeth C Randall; Begoña G C Lopez; Sen Peng; Michael S Regan; Walid M Abdelmoula; Sankha S Basu; Sandro Santagata; Haejin Yoon; Marcia C Haigis; Jeffrey N Agar; Nhan L Tran; William F Elmquist; Forest M White; Jann N Sarkaria; Nathalie Y R Agar Journal: Cancer Res Date: 2019-11-25 Impact factor: 12.701
Authors: Sun Young Kim; Ji Sung Lee; Junho Kang; Satoshi Morita; Young Suk Park; Junichi Sakamoto; Kei Muro; Rui-Hua Xu; Tae Won Kim Journal: Oncologist Date: 2021-03-23
Authors: Manvi Sharma; Holly M Holmes; Hemalkumar B Mehta; Hua Chen; Rajender R Aparasu; Ya-Chen T Shih; Sharon H Giordano; Michael L Johnson Journal: Cancer Date: 2019-01-03 Impact factor: 6.860