Abstract
BackgroundThe purpose of this study was to compare clinical outcomes of Erlotinib versus Gefitinib in the treatment of Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and newly diagnosed brain metastases.MethodsConsecutive Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and newly diagnosed brain metastases were identified and initially received peroral administration of 150 mg/d erlotinib or 250 mg/d gefitinib during 2009–2015. Overall survival (OS) was the primary endpoint. Progression-free survival (PFS) was the second endpoint.ResultsThe cohort consisted of 227 Asian patients (erlotinib-treated cohort: n = 112, mean age = 58.5 years [SD: 20.13]; gefitinib-treated cohort: n = 115, mean age = 58.4 years [SD: 19.52]). In a multivariate analysis controlling for age, sex and time span of smoking history, significant difference was detected in the 36-month OS between erlotinib and gefitinib groups (58.3% vs. 49.1%, p = 0.012). There was also significant difference in the 36-month PFS between erlotinib and gefitinib groups (64% vs. 53%, p = 0.013).ConclusionFor Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and brain metastases, erlotinib was associated with a significantly longer OS and a more prolonged PFS and compared with gefitinib.
Highlights
The purpose of this study was to compare clinical outcomes of Erlotinib versus Gefitinib in the treatment of Asian patients with exon 19 epidermal growth factor receptor (EGFR)-mutant lung adenocarcinoma and newly diagnosed brain metastases
All tumours detected were histopathologically parallel to lung adenocarcinoma with identical exon 19 EGFR mutation, excluding a second lung tumour as a possibility
In the current study, Asian patients with positive exon 19 EGFR-mutant lung adenocarcinoma and newly diagnosed brain metastases who initially received peroral administration of 150 mg/d erlotinib or 250 mg/d gefitinib were followed for a mean of 36 months, and the most important finding was that erlotinib was associated with a significantly longer overall survival (OS) and more prolonged progression-free survival (PFS) than gefitinib
Summary
The purpose of this study was to compare clinical outcomes of Erlotinib versus Gefitinib in the treatment of Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and newly diagnosed brain metastases. The data from randomized controlled trials(RCTs) and other investigations have indicated that EGFR-TKI has advantageous when used as an initial treatment for Asian patients with EGFR-mutant lung adenocarcinoma and brain metastases [5,6,7]. We conducted a retrospective review of Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and brain metastases. To our knowledge, this is the first analysis that directly compares gefitinib against erlotinib as initial treatment for brain metastases following exon 19 EGFR-mutant lung adenocarcinoma. We hypothesized that there would be differences in both OS and PFS between patients treated with gefitinib vs. erlotinib
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