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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

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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.

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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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Authors and Affiliations

  1. Department of Respiratory Medicine, Okayama University Hospital, 2-5-1, Shikata-cho, Okayama, 700-8558, Japan

    Katsuyuki Hotta, Katsuyuki Kiura, Nagio Takigawa, Yoshiro Fujiwara, Masahiro Tabata & Mitsune Tanimoto

  2. Department of Medicine, Chugoku Central Hospital, Fukuyama, Japan

    Shoichi Kuyama

  3. Department of Respiratory Medicine, NHO Shikoku Cancer Center, Matsuyama, Japan

    Yoshihiko Segawa & Akihiko Bessho

  4. Department of Respiratory Medicine, NHO Okayama Medical Center, Okayama, Japan

    Toshiro Yonei

  5. Department of Medicine, Okayama Rousai Hospital, Okayama, Japan

    Kenichi Gemba

  6. Department of Respiratory Medicine, NHO Sanyo Hospital, Ube, Japan

    Keisuke Aoe & Hiroshi Ueoka

  7. Department of Respiratory Medicine, NHO Minami-Okayama Medical Center, Okayama, Japan

    Takuo Shibayama

  8. Department of Medicine, Okayama Red Cross Hospital, Okayama, Japan

    Keisuke Matsuo

  9. Department of Medicine, Sumitomo Besshi Hospital, Niihama, Japan

    Haruhito Kamei

  10. Department of Medicine, Ehime Prefectural Central Hospital, Matsuyama, Japan

    Tomonori Moritaka

  11. Department of Medicine, NHO Fukuyama Medical Center, Fukuyama, Japan

    Keisuke Sugimoto

Authors
  1. Katsuyuki Hotta
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  2. Katsuyuki Kiura
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  3. Nagio Takigawa
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  4. Shoichi Kuyama
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  5. Yoshihiko Segawa
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  8. Keisuke Aoe
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  9. Takuo Shibayama
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  10. Keisuke Matsuo
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  11. Haruhito Kamei
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  14. Tomonori Moritaka
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  15. Keisuke Sugimoto
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  16. Masahiro Tabata
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  17. Hiroshi Ueoka
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  18. Mitsune Tanimoto
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Corresponding author

Correspondence to Katsuyuki Hotta.

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Hotta, K., Kiura, K., Takigawa, N. et al. 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. J Cancer Res Clin Oncol 135, 117–123 (2009). https://doi.org/10.1007/s00432-008-0431-1

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  • DOI: https://doi.org/10.1007/s00432-008-0431-1

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