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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Thoracic Oncology
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1412716
This article is part of the Research Topic Exploring Precision Medicine: A Deep Dive into Molecular Radiobiology View all articles

Thoracic radiation in combination with erlotinib – results from a phase 2 randomized trial

Provisionally accepted
Hanne Marte Nymoen Hanne Marte Nymoen 1Tine N. Alver Tine N. Alver 1Henrik Horndalsveen Henrik Horndalsveen 1Hanne A. Eide Hanne A. Eide 1Maria M. Bjaanæs Maria M. Bjaanæs 1Odd Terje Brustugun Odd Terje Brustugun 2Bjørn Henning Grønberg Bjørn Henning Grønberg 3,4Vilde D. Haakensen Vilde D. Haakensen 1,5Åslaug Helland Åslaug Helland 1,5*
  • 1 Oslo University Hospital, Oslo, Nordland, Norway
  • 2 Vestre Viken Hospital Trust, Drammen, Norway
  • 3 Norwegian University of Science and Technology, Trondheim, Sør-Trøndelag, Norway
  • 4 St Olav's University Hospital, Trondheim, Sør-Trøndelag, Norway
  • 5 University of Oslo, Oslo, Oslo, Norway

The final, formatted version of the article will be published soon.

    Radiotherapy can be used to reduce symptoms and maintain open airways for patients with non-small cell lung cancer when systemic treatment is not sufficient. For some patients, tumor control is not achieved due to radio-resistance. Concurrent inhibition of epidermal growth factor receptors has been proposed as a strategy to overcome radio-resistance but may increase toxicity. We performed a randomized trial to assess the efficacy, tolerance and quality of life of concurrent erlotinib and palliative thoracic radiotherapy for patients with advanced non-small cell lung cancer.Patients were randomized 1:1 to radiotherapy alone (arm A) or in combination with erlotinib (arm B). A CT scan at baseline and one at 4 -12 weeks after inclusion was used to evaluate treatment response. Adverse events were registered during treatment and the subsequent 30 days. Health-related quality of life questionnaires were completed by the patients at baseline, week 2, week 6 and week 20.A total of 114 patients were included. Of the 74 patients with CT scans available for evaluation of treatment effect, there were no significant differences in tumor size reduction between the two groups: median 14.5% reduction in the control arm A and 17.0% in the erlotinib arm B (p=0.68). Overall survival was not significantly different between the two treatment arms: 7.0 and 7.8 months in arm A and arm B, respectively (log-rank p=0.32). There was no significant increase in adverse events in the experimental arm, other than what is expected from erlotinib treatment alone. Overall, patients reported similar quality of life in both treatment arms.Concurrent erlotinib and palliative thoracic radiotherapy for patients with advanced non-small cell lung cancer was well tolerated but did not improve the efficacy of the radiotherapy.

    Keywords: Non-small cell lung cancer, radioresistance, EGFR-inhibitor, erlotinib, adverse events, Toxicity, Quality of life Astra, Roche

    Received: 05 Apr 2024; Accepted: 09 Jul 2024.

    Copyright: © 2024 Nymoen, Alver, Horndalsveen, Eide, Bjaanæs, Brustugun, Grønberg, Haakensen and Helland. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Åslaug Helland, Oslo University Hospital, Oslo, 4950, Nordland, Norway

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