Author of

• 11692

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  P2.10 - Poster Session 2 - Chemotherapy (ID 207)

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

  • 11713

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    P2.10-021 - The effect of gefitinib in patients with postoperative recurrent non-small cell lung cancer harbouring mutations of the epidermal growth factor receptor. (ID 1367)

    09:30 - 09:30  |  Author(s): R. Ko
    • Abstract

    Background
    For patients with postoperative recurrent non-small cell lung cancer (NSCLC) harbouring mutations of the epidermal growth factor receptor (EGFR), EGFR tyrosine kinase inhibitor, such as gefitinib, is frequently used in clinical practice, in accordance with the treatment for patients with stage IV NSCLC. However, it is unclear whether there is a difference in effect of gefitinib between patients with postoperative recurrent NSCLC and patients with stage IV NSCLC, harbouring EGFR mutations.

    Methods
    We reviewed consecutive patients with postoperative recurrent or stage IV (at diagnosis) NSCLC harbouring EGFR mutations, who were treated with gefitinib at the Shizuoka Cancer Center between September 2002 and March 2012. The clinical data of the patients were obtained from their medical records, and retrospectively reviewed. The baseline patient characteristics, response to gefitinib, and survival were compared between patients with postoperative recurrent NSCLC (postoperative group) and patients with stage IV NSCLC at diagnosis (stage IV group). Patients were not included if they had received other EGFR tyrosine kinase inhibitors before administration of gefitinib.

    Results
    A total of 169 patients met the eligibility criteria for this study (postoperative group; 50, stage IV group; 119). The baseline characteristics (sex, age, histology, EGFR mutations status, prior cytotoxic chemotherapy) were well balanced between both groups, with the exception of performance status (PS). Patients in postoperative group had better PS than those in stage IV group (p = 0.044). At the start of treatment with gefitinib, bone and liver metastases were more common in stage IV group (p = 0.002 and p = 0.032), and pulmonary metastases were more common in postoperative group (p = 0.004). There was no significant difference in number of metastatic sites between two groups. The response rate of gefitinib in postoperative group was similar to that in stage IV group (58 vs 61%, p = 0.685). In contrast, progression free survival (PFS) (median PFS 16.7 vs 9.8 months, p < 0.001) and overall survival (OS) (median OS 63.3 vs 23.9 months, p < 0.001) were significantly longer in postoperative group than in stage IV group. Additionally, postoperative recurrent disease, PS (0-1) and single metastatic site were independent prognostic factors in the multivariate analysis of survival.

    Conclusion
    PFS and OS were superior in patients with postoperative recurrent NSCLC harbouring EGFR mutations treated by gefitinib than in those with stage IV disease. These results suggest, postoperative recurrent disease may be considered to be a stratification factor in clinical trial for NSCLC with EGFR mutations.