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K. Ohta
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P3.01 - Poster Session/ Treatment of Advanced Diseases – NSCLC (ID 208)
- Event: WCLC 2015
- Type: Poster
- Track: Treatment of Advanced Diseases - NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 9/09/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P3.01-017 - P53 Disruptive Mutation Is a Negative Predictive Factor in EGFR M+ NSCLC Treated with TKIEfficacy and Safety of Gefitinib for Elderly Patients with EGFR Mutation Positive NSCLC (ID 904)
09:30 - 09:30 | Author(s): K. Ohta
- Abstract
Background:
Elderly patients with lung cancer have been increasing. Of all cases of lung cancer 47% were 70 years or older and 14% were 80 years or older. Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is a key drug for patients with EGFR mutation positive advanced non-small cell lung cancer (NSCLC). Although treatment of gefitinib is known to have fewer myelosuppression and gastrointestinal adverse events than cytotoxic chemotherapy, treatment of gefitinib frequently has skin rash and liver dysfunction. Until now, there have been few reports of the efficacy and safety of gefitinib in elderly patients with advanced NSCLC. Therefore, the efficacy and safety of treatment of gefitinib in elderly patients with EGFR mutation positive advanced NSCLC have yet to be confirmed.
Methods:
We retrospectively assessed the efficacy and safety of gefitinib in 52 patients with EGFR mutation positive advanced NSCLC who were 70 years older and were treated with gefitinib. In addition, we compared the frequency and severity of adverse effects between patients 70 to 79 years and patients 80 years or older.
Results:
Of 52 patients, 35 (67%) were female and 13 (25%) were performance status of 2 or more, and the median age was 75 (range, 70-89 years). Fifteen patients (29%) were 80 years or older. All patients were adenocarcinoma. The type of EGFR mutation was as follows: 28 patients (54%) had exon 19 deletion, 23 (44%) had exon 21 L858R, and 1 (2%) had exon 18 G719A. The response rate was 73.1% (95% CI, 59.0% to 84.4%) and the disease control rate was 90.4% (95% CI, 79.0 to 96.8%). The median time to progression was 10.7 months (range, 0 to 36.2 months). The median survival time was 23.8 months (range, 0.2 to 65.6 months). The common adverse events were skin rash (52%), liver dysfunction (29%), diarrhea (25%), and interstitial lung disease (4%). Doses of gefitinib were reduced in 12 patients (23%) and discontinued in 11 patients (21%) due to toxicity, mainly skin rash and liver dysfunction. There were no differences in response rates, disease control rates, survivals, adverse events, and dose reduction rates between patients 70 to 79 years and patients 80 years or older.
Conclusion:
Treatment of gefitinib is highly effective for elderly patients with EGFR mutation positive advanced NSCLC, although dose reduction rates were more frequent in elderly patients than those in recently published trials in younger patients.
