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Erlotinib Dosing in Lung Cancer Depends on Smoking Status CORONADO, Calif -- January 13, 2009 -- Although erlotinib is an approved second-line therapy for lung cancer, its management is complicated by side effects that get worse as the dose increases. “Increased doses may lead to better outcomes, so we are trying to determine how high we can go with this agent without having to stop,” said Lynsay Waller, MD, Wake Forest University, Winston-Salem, North Carolina. Dr. Waller presented the data at the American Association for Cancer Research / International Association for the Study of Lung Cancer Joint Conference on Molecular Origins of Lung Cancer, on January 12. For the study, Dr. Waller and colleagues evaluated 25 patients with lung cancer. The researchers administered a chemotherapy regimen that began with docetaxel, cisplatin, and pegfilgrastim growth factor support to all patients. The researchers then started administering erlotinib at 150 mg daily for non-smokers and 300 mg daily for smokers. These doses were increased every 2 weeks until development of grade 2 toxicity, when the doses stabilised. If grade 3 toxicity emerged, the doses were cut back by 75 mg a day. Doses reached as high as 525 mg for smokers and 225 mg for non-smokers, but by the end of the study most smokers had a maximum tolerated dose of 300 mg compared with 225 mg for non-smokers. The most common reasons for discontinuation of therapy was grade 2 rash, grade 2 or grade 3 diarrhoea, or grade 3 dehydration. SOURCE: American Association for Cancer Research E-mail this page to a friend or colleague! To print, use this version