Patients with non small-cell lung cancer stage IV et IIIB (T4 with pleural effusion) in elderly dependent patients

Inclusion Criteria:

• Age > 65
• Comorbidities score, PS and frailty score according to table 1
• No dementia, faecal or urinary incontinence, repeated falls
• ADL = 0, IADL = 0-1
• Life expectancy at least 12 weeks
• Creatinin clearance > = 30 ml/mn (according to Cockcrofts-Gault formula)
• Competency to give written informed consent
• Haematological functions as follows : neutrophiles count > 1.5 x 109/l and platelets > 100 x 109/l hemoglobin > 9,5 g/dl - Hepatic function as follows : Bilirubin < 1,25 LNS ASAT / ALAT <5 x NAlcPh <5 x N
• PS < 3
• cerebral metastasis eligible if asymptomatic
• Histologically or cytologically confirmed NSCLC
• Stage IV/IIIB4 (T4 with pleural effusion)
• No prior chemotherapy
• relapses of previous NSCLC treated by surgery or radiotherapy are eligible, if the target is measurable out of initial radiotherapy field and if cytological or histological proof
• At least one measurable target lesion by RECIST guidelines

Exclusion Criteria:

• symptomatic cerebral metastasis
• Any severe comorbidity calculated by Charlson score according to table 1
• ADL > 0 and IADL > 1- performance status >2 (ECOG)
• peripheral neuropathy grade 2 or more
• dementia, repeated falls, urinary or faecal incontinence
• contra-indication to corticosteroids
• contra indication to a product of this study
• unwilling or unable to comply with study requirements, for personal, family, sociologic, geographic or any other reason
• inability of the subject to give written informed consent
• lack of liberty following legal or administrative decision
• hypersensitivity to polysorbate
• hypersensitivity to erlotinib or any excipients of this product
• unusual hereditary disorders, as galactosemia, deficit in lactase and syndrome of malabsorption in glucose or galactose
• participation in concomitant clinical trial
• bronchioloalveolar or neuroendocrine or composite carcinoma
• superior vena cava syndrome