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Sex difference in the influence of smoking status on the responsiveness to gefitinib monotherapy in adenocarcinoma of the lung: Okayama Lung Cancer Study Group experience

  • Katsuyuki HottaEmail author
  • Katsuyuki Kiura
  • Nagio Takigawa
  • Shoichi Kuyama
  • Yoshihiko Segawa
  • Toshiro Yonei
  • Kenichi Gemba
  • Keisuke Aoe
  • Takuo Shibayama
  • Keisuke Matsuo
  • Haruhito Kamei
  • Yoshiro Fujiwara
  • Akihiko Bessho
  • Tomonori Moritaka
  • Keisuke Sugimoto
  • Masahiro Tabata
  • Hiroshi Ueoka
  • Mitsune Tanimoto
Original Paper

Abstract

Background

Gefitinib is effective in patients with lung adenocarcinoma. Smoking status also affects the responsiveness to gefitinib, but it has not been fully evaluated whether a sex difference exists in the influence of smoking on the efficacy of gefitinib in patients with lung adenocarcinoma.

Methods

We reviewed the clinical records of 260 Japanese patients with lung adenocarcinoma who received gefitinib therapy (250 mg/day), and whose smoking status was known. Tumour response and survival were evaluated and stratified by smoking status and gender.

Results

Among the 260 patients, 157 were male (60%). Median pack-years was 40 (range 8–160) and 23 (range 1–74) in male and female smokers, respectively. Objective response was observed in 62 (23.8%) of the 260 patients, and 1-year overall survival and progression-free survival were 45.1 and 24.3%, respectively. Multivariate analysis revealed that smoking status (pack-years) was an independent predictive factor for response to gefitinib [odds ratio (OR) = 0.971, 95% confidence interval (CI) = 0.947–0.995; P = 0.0159] in male patients, but not in female patients (OR = 0.999, 95%CI = 0.957–1.042). Additionally, pack-years significantly influenced the overall survival in males (hazard ratio = 1.010; 95%CI = 1.002–1018, P = 0.0169), while differential survival of females was not significantly predicted by this factor (P = 0.7639).

Conclusions

In male patients with lung adenocarcinoma, cumulative smoking significantly affected response and survival following gefitinib treatment, while in female patients, responsiveness to gefitinib was independent of smoking status. These results suggest that the influence of smoking habit on responsiveness to gefitinib is gender specific.

Keywords

Gefitinib Gender Non-small-cell lung cancer Objective response Smoking status 

Notes

Acknowledgments

We thank Drs. Tadashi Maeda, Atsuko Ogino, Shigeki Umemura, Keiichi Fujiwara, Toshiyuki Kozuki, Toshiaki Okada, Akiko Hisamoto, Naoyuki Nogami, Ichiro Takata, Hideki, Hiroaki Miyamoto and Shingo Harita for their support, data provision, and comments on the analysis.

Conflict of interest statement

None.

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Copyright information

© Springer-Verlag 2008

Authors and Affiliations

  • Katsuyuki Hotta
    • 1
    Email author
  • Katsuyuki Kiura
    • 1
  • Nagio Takigawa
    • 1
  • Shoichi Kuyama
    • 2
  • Yoshihiko Segawa
    • 3
  • Toshiro Yonei
    • 4
  • Kenichi Gemba
    • 5
  • Keisuke Aoe
    • 6
  • Takuo Shibayama
    • 7
  • Keisuke Matsuo
    • 8
  • Haruhito Kamei
    • 9
  • Yoshiro Fujiwara
    • 1
  • Akihiko Bessho
    • 3
  • Tomonori Moritaka
    • 10
  • Keisuke Sugimoto
    • 11
  • Masahiro Tabata
    • 1
  • Hiroshi Ueoka
    • 6
  • Mitsune Tanimoto
    • 1
  1. 1.Department of Respiratory MedicineOkayama University HospitalOkayamaJapan
  2. 2.Department of MedicineChugoku Central HospitalFukuyamaJapan
  3. 3.Department of Respiratory MedicineNHO Shikoku Cancer CenterMatsuyamaJapan
  4. 4.Department of Respiratory MedicineNHO Okayama Medical CenterOkayamaJapan
  5. 5.Department of MedicineOkayama Rousai HospitalOkayamaJapan
  6. 6.Department of Respiratory MedicineNHO Sanyo HospitalUbeJapan
  7. 7.Department of Respiratory MedicineNHO Minami-Okayama Medical CenterOkayamaJapan
  8. 8.Department of MedicineOkayama Red Cross HospitalOkayamaJapan
  9. 9.Department of MedicineSumitomo Besshi HospitalNiihamaJapan
  10. 10.Department of MedicineEhime Prefectural Central HospitalMatsuyamaJapan
  11. 11.Department of MedicineNHO Fukuyama Medical CenterFukuyamaJapan

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