Author of

• 11745

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  P2.11 - Poster Session 2 - NSCLC Novel Therapies (ID 209)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/29/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 11748

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    P2.11-003 - How to make the choice in the reuse of EGFR-TKI for advanced NSCLC patients who benefited from prior Gefitinib therapy: the original drug or switching to a second EGFR-TKI? (ID 831)

    09:30 - 09:30  |  Author(s): W. Wang
    • Abstract

    Background
    For advanced NSCLC patients who benefited from prior EGFR-TKI therapy, the choice of a second TKI therapy has gradually become a new strategy for the treatment. Some investigators recommend that the second therapy should be continued with the original TKI; however, other investigators recommend the administration of another TKI. This study aims to discuss which choice is more reasonable.

    Methods
    In retrospect, patients with advanced NSCLC or with postoperative relapse of advanced NSCLC achieved CR, PR or SD in prior Gefitinib therapy, PFS≥3 months. They received repeated Gefitinib or Erlotinib at an interval of at least one month. The analysis was carried out with respect to efficacy and optimal population of the two groups.

    Results
    A total of 61 patients were enrolled into the study, 30 in Gefitinib group and 31 in Erlotinib group. Baseline characteristics of the two groups were comparable. Among these patients, overall response rate was 16.4% (10/61), disease control rate was 67.2% (41/61), median PFS was 3.5 months (95%CI 3.0-4.0 months), median OS was 8.5 months (95%CI 7.0-11 months). In the comparison between patients treated with Gefitinib and with Erlotinib, no statistical differences were seen for response rate (10% vs 22.6%, P=0.3006), disease control rate (60% vs 74.2%, P=0.2378), median PFS (3.0 vs 3.5 months, P=0.4945), or median OS (8.3 vs 8.5 months, P=0.1408). Multivariate analysis showed that in the initial dose of Gefitinib, PFS≥6 months (HR 0.317, 95%CI 0.102-0.984, P=0.0469). With an interval ≥3 months (HR 0.224，95%CI 0.071-0.713,P=0.0113) between two doses of TKI, the risk of disease progression was reduced; but if with an interval ≥3 months (HR 0.262, 95%CI 0.097-0.705,P=0.0080), the risk of death was reduced.

    Conclusion
    Advanced NSCLC patients who benefited from prior Gefitinib therapy can benefit again either with the original drug Gefitinib or the alternative drug Erlotinib when a second TKI therapy is resumed. Such benefit is related to PFS of initial TKI therapy and time interval between two doses of TKI.