Abstract
The reversible EGFR tyrosine kinase inhibitors gefitinib and erlotinib are approved for first-line treatment of EGFR mutation-positive non-small-cell lung cancer (NSCLC). However, here is paucity of data on their efficacy from the Indian subcontinent. This is a retrospective analysis including 43 patients. These patients were treated at a tertiary care center in north India. Advanced NSCLC patients (stage IV) having sensitive EGFR mutation who were treated with gefitinib (250 mg per day) or erlotinib (150 mg per day) were analyzed for their outcome. Subgroup analysis by EGFR mutation (18, 19, 20, 21), sex and status according to brain metastasis was also done using SPSS. 43 patients with stage IV non-squamous NSCLC with EGFR sensitive mutation were treated with first line TKI. There were 16 male and 27 female patients with mean age of 62.5 years (ranging from 43 to 85 years). Mean PFS for all the patients on first line TKI was 11.63 months Mean PFS for male patients was 9.93 months and for female patients it was 12.7 month. There were 26 patients with exon 19 deletions and 16 with exon 21 mutation and 1 with exon 18 mutation. Mean PFS in patients with exon 19 deletions was 11.11 months and 10.44 months in patients with exon 21 mutation. Mean PFS in patients on erlotinib was 12.27 months (CI 6.2-18.3) and 11.4 months in patients on gefitinib. Twelve patients (27.9%) out of 43 had brain metastases. PFS of these 12 patients was 10.33 months and 12.08 months for patients without brain metastases. Erlotinib and gefitinib significantly improves PFS in patients with sensitive EGFR mutations. PFS is better in female patients, exon 19 mutation/deletion and without brain metastases in North Indian population.
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