1289P - Treatments and Outcome of NSCLC Patients who Receive Gefitinib for More than Three Years

Abstract

ABSTRACT Background Non-small cell lung cancer (NSCLC) patients harboring epidermal growth factor receptor (EGFR) mutation initially respond well to gefitinib, but most of them revealed acquired resistance after approximately 10 months. However, some patients can obtain clinical benefit from gefitinib for several years. Little is known regarding characteristics, clinical course, and treatment strategy of these patients. The aim of our study was to evaluate how these patients obtain longer clinical benefit, by analysis for patients receiving gefitinib for over three years. Methods Between July 2002 and September 2011, 18 NSCLC patients received gefitinib for more than three years. We retrospectively evaluated patient characteristics, treatment strategy, prescription period, progression-free survival (PFS), and overall survival (OS) from gefitinib initiation. Results Median age was 71 (range: 50-87), male/female = 3/15, All of them had adenocarcinoma, performance status (PS) 0 or 1 / 2 = 17/1, smoking status: never/former =13/5, previous treatment regimen:0/1/2 = 5/8/5, EGFR mutation status: mutated/wild-type/unknown = 7/3/8, mutation site: exon 19 (deletion) / exon 21 (L858R)/others = 4/2/1, stage: recurrence/stage IV = 10/8. Five patients still continue gefitinib without disease progression (PD). Among 13 patients with PD, 4 switched to another regimen, 2 received local treatments (metastectomy and stereotactic body radiation therapy) for progressive primary site, 7 continued gefitinib in spite of progressive disease status, and 3 of 7 continued gefitinib with radiotherapy to progressive metastatic sites (brain and bone). Median prescription period, PFS, and OS from gefitinib initiation were 54.0 months (95% confidence interval (CI): 47.8, 61.7 months), 47.9 months (95%CI: 36.4, 74.9 months), and 80.2 months (95%CI: 62.0, undeterminable months), respectively. Conclusions In patients receiving gefitinib over 3 years, median survival was notably over 80 months. Even after PD, multimodal personalized therapy with continuous gefitinib administration and/or additional local treatment may prolong survival of some NSCLC patients with EGFR mutation. Disclosure All authors have declared no conflicts of interest.