Prospective study of gefitinib readministration after chemotherapy in patients with advanced non-small-cell lung cancer who previously responded to gefitinib.

Abstract

INTRODUCTION:

Salvage treatment for acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitor in patients with non-small-cell lung cancer is a matter of clinical concern. Several retrospective reports have indicated the usefulness of epidermal growth factor receptor tyrosine kinase inhibitor readministration; however, there have been few prospective studies.

MATERIALS AND METHODS:

This study was designed to prospectively evaluate the clinical efficacy of gefitinib readministration in patients with advanced or metastatic non-small-cell lung cancer who responded well to initial gefitinib treatment. The subjects received at least 1 regimen of cytotoxic chemotherapy after progressive disease with the initial gefitinib therapy. Gefitinib administration (250 mg/d, orally) was started after progressive disease with the previous chemotherapeutic regimen. The primary endpoint in the present study was the response rate.

RESULTS:

Twenty patients were enrolled between April 2007 and May 2011. Three patients achieved partial response, and 6 showed stable disease. Thus, the overall response rate and disease control rate of gefitinib readministration were 15% (95% CI, 3.21-37.9) and 45% (95% CI, 23.1-68.5), respectively. Median progression-free survival and overall survival from the start of gefitinib readministration were 2.0 months (95% CI, 0.9-3.1 months) and 12.0 months (95% CI, 8.0-16.0 months), respectively.

CONCLUSION:

These results suggest that gefitinib readministration may be an option, albeit with a low response rate and short progression-free survival, for patients who responded well to initial gefitinib followed by systemic chemotherapy. These findings provide valuable information for the management of previous gefitinib responders.

• Authors: Tomonobu Koizumi, Toshihiko Agatsuma, Kayoko Ikegami, Toshiro Suzuki, Takashi Kobayashi, Shintaro Kanda, Sumiko Yoshikawa, Keishi Kubo, Takayuki Shiina, Keiichirou Takasuna, Akemi Matsuo, Muneharu Hayasaka, Miwa Morikawa, Shingo Ameshima
• Journal: Clinical lung cancer (Clin Lung Cancer) Vol. 13 Issue 6 Pg. 458-63 (Nov 2012) ISSN: 1938-0690 [Electronic] United States
• PMID: 22402083 (Publication Type: Clinical Trial, Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Antineoplastic Agents
• Protein Kinase Inhibitors
• Quinazolines
• Gefitinib

Topics

• Administration, Oral
• Adult
• Aged
• Aged, 80 and over
• Antineoplastic Agents (therapeutic use)
• Carcinoma, Non-Small-Cell Lung (drug therapy, pathology)
• Disease-Free Survival
• Female
• Gefitinib
• Humans
• Lung Neoplasms (drug therapy, pathology)
• Male
• Middle Aged
• Prospective Studies
• Protein Kinase Inhibitors (therapeutic use)
• Quinazolines (therapeutic use)
• Retreatment
• Salvage Therapy
• Survival Rate
• Treatment Outcome