Clinical investigation of IRESSA in the treatment of patients with advanced refractory non-small cell lung cancer

Abstract

Chemotherapy is a main method for patients with advanced non-small cell lung cancer (NSCLC). NSCLC is usually a drug-resistant neoplasm. Innate or acquired drug-resis-tance contributes to the chief cause for bad effect in the treatment of patients with NSCLC. To search for a new anti-cancer drug becomes a goal of clinical oncologists. The aim of the present study is to evaluate the curative effect and side reactions of IRESSA in the treatment of patients with advanced refractory NSCLC. The curative investigation was carried out after 100-day oral IRESSA by a dosage of 250mg/d in patients with advanced refractory NSCLC. The patients had ever experienced at least one regimen of chemotherapy. Totally 33 patients enrolled in this study and all were stage IV. There were 25 males and 8 females. All enrolled patients except one patient who died of severe adverse side reaction completed treatment by IRESSA. Thirty-two cases were evaluated. Complete response was obtained in 1 patient (3.1%). Partial response was seen in 11 patients (34.4%). The overall effective rate was 37.5% (12/32). The disease-control rate was 65.6% (21/32). Time to progression was 5.7 months. Overall survival time was 3.3 to 25.9 months (median survival time was 9.6 months). One-year survival rate was 28.1% (9/32). Two-year survival rate was 6.3% (2/32). The longest survivor lived for 25.9 months. The curative effect was correlated with the pathological type, in sequence of alveolar cell carcinoma, adenocarcinoma and squamous cell carcinoma. Almost all the adverse reactions were acceptable. The main adverse reactions included rash, itching of skin, arthralgia, diarrhea, anorexia, nausea, vomiting, dizziness, headache, chest distress and abdominal pain. No patients showed abnormal in liver or kidney function. No electrocardiogram abnormality was found. One patient who had chronic pulmonary fibrosis before died of respiratory failure due to severe interstitial pneumonia. IRESSA takes better effect on the advanced drug-resistant patients with NSCLC. So IRESSA may be accepted as third line in the treatment of advanced NSCLC and as first line in the treatment of patients with bad constitution who have no opportinities for operation, irradiation therapy or chemotherapy.