€OBJECTIVES: Median age of newly diagnosed non small cell lung cance (NSCLC) is 70 years (with 1/3 older than 75 years) and elderly are more vulnerable to chemotherapy. In this population, weekly gemcitabine and docetaxel or erlotinib are both active in advanced NSCLC treatment. The GFPC0504 randomized prospective phase 2 study assess in fit elderly patients with advanced NSCLC, efficacy of weekly chemotherapy followed by erlotinib if progression (Arm A) versus erlotinib followed by chemotherapy if progression (arm B). The main objective of this study was time before second progression, secondary objective was overall survival. The objective of this study is to assess the cost-effectiveness of erlotinib in 1st line treatment of NSCLC in fit elderly patients. METHODS: Outcomes (PFS and overall survival) and direct medical costs until second progression (from the third party payer perspective) were prospectively collected. Costs after second progression and health utilities (based on disease states and grade 3-4 toxicities) were derived from the literature. RESULTS: For respectively 48 and 51 patients randomised respectively in arm A and B PFS were 6.4 and 5.2 months, overall survival were 9.2 and 7.9 months; mean Qualy and mean direct costs (euros value 2010)  were respectively  €0.434 ± €0.394 and €26,297 ± €25,297 and €0.471± €0.451 and €25,948 ± €18,206, Acceptability curve will be presented at the meeting. CONCLUSIONS: In this population of fit ederly patients, erlotinb in first line, followed by chemotherapy if progression appears as dominant compare to chemotherapy followed by erlotinib if progression.