A study published in JAMA Oncology supported the efficacy of first-line erlotinib therapy in Asian patients with epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC) and demonstrated that treatment beyond disease progression is feasible and may delay salvage therapy in certain patients.1

Because it is uncertain as to whether to continue molecularly targeted treatment beyond disease progression in NSCLC, researchers sought to identify whether progression is the optimal time to switch treatment.

For the open-label, single-arm, phase 2 ASPIRATION study, researchers enrolled 208 patients who were receiving treatment at 23 centers in Hong Kong, Korea, Taiwan, and Thailand. Participants had stage 4, EGFR mutation-positive NSCLC and an Eastern Cooperative Oncology Group performance status between 0 and 2.

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All patients received erlotinib 150 mg orally daily until disease progression. At the point of progression, therapy could be continued at the discretion of the patient and/or investigator.

Results showed that at a median follow-up of 11.3 months (95% CI, 10.9 – 13.0), median progression-free survival was 10.8 months (95% CI, 9.2 – 11.1) among 207 evaluable patients. Of the 176 patients who had a progression-free survival event, 78 discontinued treatment and 93 continued erlotinib therapy following progression. Among the 93 patients who continued treatment, median progression-free survival was 11.0 months (95% CI, 9.3 – 12.0) during the time to progression or death and 14.1 months (95% CI, 12.2 – 15.9) during the time to off-erlotinib.

In addition, overall response rate and disease control rate were 66.2% and 82.6%, respectively. Median overall survival was 31.0 months (95% CI, 27.3 – not reached).


  1. Park K, Yu C-J, Kim S-W, et al. First-line erlotinib therapy until and beyond response evaluation criteria in solid tumors progression in Asian patients with epidermal growth factor receptor mutation–positive non–small-cell lung cancer [published online ahead of print December 30, 2015]. JAMA Oncol. doi: 10.1001/jamaoncol.2015.4921.