First- or second-line gefitinib therapy in unknown epidermal growth factor receptor mutants of non-small cell lung cancer patients.

Abstract

7577 Background: Gefitinib is effective in treating patients of non-small cell lug cancer (NSCLC). The response rate and the improvement of survival are related to several aspects, including race, sex, smoking status and histology. However, several recent reports in the literature have attributed the response to mutations of epidermal growth factor receptor (EGFR). Little is known about the survival in the different time-line of gefitinib treatment. Methods: Patients with inoperable NSCLC who received gefitinib therapy from March 2003 to December 2006 were analyzed in a tertiary-referral teaching hospital in southern Taiwan. The tumor response, survival time, timing of treatment and several possible predictors were collected to analyze the relationships. Results: One hundred and forty-nine patients who had gefitinib as first or second line therapy were included in the study. The overall survival of first and second line gefitinib therapy was 12.8 months and 20.7 months, respectively (p = 0.110). There was also no significant difference in progression free survival (6.8 months vs. 4.9 months; p = 0.415). The objective tumor response and disease control rate were similar between these two settings. Female gender, adenocarcinoma, nonsmoker, and good performance status were associated with better prognosis and tumor response. The overall survival of patients with second-line treatment compared to first time treatment preceding chemotherapy was longer with significance (p = 0.041). Conclusions: The overall survival, progression free survival and tumor response rate were similar in the patients who received gefitinib as initial therapy or after conventional chemotherapy. The overall survival in patients who received first-line gefitinib therapy and sequential chemotherapy was shorter than in those with second-line treatment. No significant financial relationships to disclose.