Gefitinib treatment in patients with postoperative recurrent non-small-cell lung cancer harboring epidermal growth factor receptor gene mutations
- 281 Downloads
The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor gefitinib is an effective treatment for recurrent or advanced lung cancer harboring EGFR gene mutations, and has improved progression-free survival in several clinical trials. However, the effect of gefitinib treatment for recurrent lung cancers with EGFR gene mutations after complete resection and the influence of the timing of such treatment have not been fully elucidated in a practical setting.
We investigated 64 patients (median age: 68 years; men: 22; women: 42; adenocarcinoma: 61; adenosquamous cell carcinoma: 2; combined large cell neuroendocrine carcinoma: 1) with recurrent lung cancer after complete resection who received gefitinib for the recurrent lesions and in whom the tumors had EGFR gene mutations. Progression-free survival, response rate, and safety were analyzed.
Complete response and partial response were achieved in 2 patients and in 42 patients, respectively (objective response rate: 69 %). Stable disease was obtained in 16 patients, the disease control rate was 94 %, and median progression-free survival was 16 months. The timing of gefitinib treatment (first line, second line, or later) and the type of EGFR gene mutation present did not influence progression-free survival. However, a smaller number of recurrent sites at the start of gefitinib treatment was linked to better progression-free survival. Hematologic and nonhematologic toxicities were generally mild, but 1 patient experienced interstitial lung disease.
Our results suggest that gefitinib treatment for recurrent lung cancer with gene EGFR mutations is a useful option in a practical setting, irrespective of the timing of such treatment and the type of EGFR gene mutation present.
KeywordsLung cancer Epidermal growth factor receptor Postoperative recurrence Gefitinib
This study was not supported by any fund, trader, or manufacturer.
Conflict of interest
The authors declare that they have no conflict of interest.
- 1.Masuda M, Kuwano H, Okumura M et al; Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery (2014) Thoracic and cardiovascular surgery in Japan during 2012: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg 62:734–764Google Scholar
- 3.Non-Small Cell Lung Cancer Collaborative Group (2010) Chemotherapy and supportive care versus supportive care alone for advanced non-small cell lung cancer. Cochrane Database Syst Rev. 5:CD007309. doi: 10.1002/14651858.CD007309.pub2
- 10.Fukuoka M, Wu YL, Thongprasert S et al (2011) Biomarker analyses and final overall survival results from a phase III, randomized, open-label, first-line study of gefitinib versus carboplatin/paclitaxel in clinically selected patients with advanced non-small-cell lung cancer in Asia (IPASS). J Clin Oncol 29:2866–2874CrossRefPubMedGoogle Scholar
- 12.Rosell R, Carcereny E, Gervais R et al (2012) Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial. Lancet Oncol 13:239–246CrossRefPubMedGoogle Scholar
- 16.Katayama T, Matsuo K, Kosaka T et al (2010) Effect of gefitinib on the survival of patients with recurrence of lung adenocarcinoma after surgery: a retrospective case-matching cohort study. Surg Oncol 19:e144–e149Google Scholar
- 18.Travis WD, Brambilla E, Muller-Hermelink HK et al (2004) World Health Organization classification of tumours: pathology and genetics of tumours of the lung, pleura, thymus and heart. IARC, LyonGoogle Scholar
- 19.Vallières E, Shepherd FA, Crowley J et al (2009) International Association for the Study of Lung Cancer International Staging Committee and participating institutions. The IASLC Lung Cancer Staging Project: proposals regarding the relevance of TNM in the pathologic staging of small cell lung cancer in the forthcoming (seventh) edition of the TNM classification for lung cancer. J Thorac Oncol 4:1049–1059Google Scholar