Introduction: Erlotinib is an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor used in the treatment of non-small cell lung cancer (NSCLC). Erlotinib was subsidised on the Pharmaceutical Benefits Scheme (PBS) for the treatment of advanced stage (IIIB or IV) NSCLC (August 2008). The trials supporting PBS subsidy showed there was a 0.2 months (95% CI 0.65-1.68) difference in survival between erlotinib and standard chemotherapy -in favour of chemotherapy. Patients who have an activating EGFR mutation have better survival outcomes compared to those without. It is unclear what survival outcomes are seen in a ‘real world’ setting.
Aims: To examine the use of erlotinib in NSCLC patients in a ‘real world’ setting and compare outcomes to the trials used to support PBS subsidy.
Methods: Data was extracted from the electronic oncology prescribing system from two large metropolitan public hospitals for NSCLC patients assigned erlotinib (1/9/2009 to 1/2/2015). Survival estimates and analyses were performed using Kaplan-Meier curves.
Results: There were 617 erlotinib doses ordered, and 134 patients received at least one dose of erlotinib. There were 113 patients deceased at the date of data extraction. Median patient age was 64 yrs, and 55% were male. Median treatment time was 2.0 months. Median overall survival (OS) was 5.8 months (95%CI 0.422, 0.592). Median progression free survival (PFS), defined as time from start of erlotinib to disease progression or death from any cause, was 3.5 months (95%CI 0.422, 0.592).
Conclusions: The use of erlotinib in the clinical setting was similar to the trials supporting PBS subsidy. Median OS at the Queensland sites was 5.8 months compared to ~ 6.0 months in trials. Outcomes for patients treated at the Queensland sites are similar to those treated in the trials.