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First-line gefitinib treatment in elderly patients (aged ≥75 years) with non-small cell lung cancer harboring EGFR mutations

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Abstract

Purpose

The efficacy of gefitinib [an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor] in elderly patients with non-small cell lung cancer (NSCLC) and EGFR mutation has not been elucidated. Therefore, the objective of this study was to investigate the efficacy and feasibility of gefitinib in elderly chemotherapy-naive patients with NSCLC harboring sensitive EGFR mutations.

Methods

We retrospectively evaluated the clinical effects of gefitinib as a first-line treatment for elderly (≥75 years) NSCLC patients with EGFR mutations (exon 19 deletion or exon 21 L858R mutation). All patients were initially treated with gefitinib (250 mg/day) at seven institutions.

Results

Between January 2006 and December 2012, 62 patients (17 men, 45 women) with a median age of 80 years (range, 75–89 years) were included in our analysis. The overall response and disease control rates were 61.2 and 83.8 %, respectively, and the median progression-free survival and overall survival were 13.2 and 19.0 months, respectively. Common adverse events included rash, diarrhea, and liver dysfunction. Major grade 3 or 4 toxicities included skin rash (3.2 %) and increased levels of aspartate aminotransferase or alanine aminotransferase (21.0 %). Gefitinib treatment was discontinued owing to adverse events of liver dysfunction in 3 patients, drug-induced pneumonitis in 2, and diarrhea in 1.

Conclusion

First-line gefitinib could be a preferable standard treatment in elderly patients with advanced NSCLC harboring sensitive EGFR mutations.

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Acknowledgments

We thank Drs. Takashi Osaki, Mie Kotake, Yosuke Kamide, Akihiro Ono, and Yasuhiko Koga for their assistance in preparing this manuscript.

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    Authors and Affiliations

    1. Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma, 371-8511, Japan

      Tomohito Kuwako, Hisao Imai, Tomomi Masuda, Kaori Seki, Noriaki Sunaga, Takeshi Hisada & Masanobu Yamada

    2. Division of Respiratory Medicine, Gunma Prefectural Cancer Center, Ohta, Gunma, Japan

      Yosuke Miura & Koichi Minato

    3. Division of Respiratory Medicine, National Hospital Organization Nishigunma Hospital, Shibukawa, Gunma, Japan

      Reiko Yoshino, Yoshio Tomizawa & Ryusei Saito

    4. Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

      Kyoichi Kaira

    5. Division of Internal Medicine, Kiryu Kosei General Hospital, Kiryu, Gunma, Japan

      Mitsuyoshi Utsugi

    6. Department of Thoracic Visceral Organ Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

      Kimihiro Shimizu

    7. Division of Internal Medicine, Isesaki Municipal Hospital, Isesaki, Gunma, Japan

      Shinichi Ishihara

    8. Division of Internal Medicine, Public Tomioka General Hospital, Tomioka, Gunma, Japan

      Takao Ishizuka

    9. Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

      Akira Mogi

    10. Division of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan

      Atsushi Takise

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    1. Tomohito Kuwako
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    Correspondence to Hisao Imai.

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    T. Kuwako and H. Imai have contributed equally to this work.

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    Kuwako, T., Imai, H., Masuda, T. et al. First-line gefitinib treatment in elderly patients (aged ≥75 years) with non-small cell lung cancer harboring EGFR mutations. Cancer Chemother Pharmacol 76, 761–769 (2015). https://doi.org/10.1007/s00280-015-2841-5

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