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Initial Progression-Free Survival after Non-First Line TKIs Therapy Potentially Guides Immediate Treatment after Its Failure in Advanced Non-Small Cell Lung Cancer.

Wang F, Guo GF, Qiu HJ, He WZ, Zhou FF, Chen XX, Hu PL, Zhang B, Yin CX, Zhang L, Xia LP - Cancer Biol Med (2012)

Bottom Line: The standard therapy after failure of the initial non-first line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment in advanced non-small cell lung cancer (NSCLC) has not yet been established.The paclitaxel-containing regimen may improve the 2(nd) PFS.However, more patient samples are urgently needed to validate these findings.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.

ABSTRACT

Objective: The standard therapy after failure of the initial non-first line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment in advanced non-small cell lung cancer (NSCLC) has not yet been established. The aim of the current study was to identify whether the 2(nd) TKI treatment or chemotherapy (paclitaxel-containing or non-paclitaxel regimen) is the appropriate treatment for patients with NSCLC based on the efficacy of the initial TKIs.

Methods: Seventy-two advanced NSCLC patients who had accepted 2(nd) TKIs or chemotherapy immediately after failure of the initial TKIs in non-first line setting from May 1, 2004 to January 31, 2010 at the Sun Yat-sen University Cancer Center were enrolled. The primary endpoint [2(nd) progression-free survival (PFS)] and the second endpoint [overall survival (OS)] were compared among the 2(nd) TKI and chemotherapy groups as well as their subgroups.

Results: (1) Twenty-one patients were treated with 2(nd) TKIs, and 51 patients were administered chemotherapy after failure of the initial non-first line TKI treatment. There was nonsignificant difference in the responses (P=0.900) [2(nd) PFS (P=0.833) and OS (P=0.369)] between the 2(nd) TKI and chemotherapy groups. (2) In the 2(nd) TKI group, 9 patients exhibited PFS≥7 months. The initial TKI treatment group exhibited a longer 2(nd) PFS than the other 12 patients with an initial PFS<7 months (7 months vs. 2 months, P=0.019). However, these groups had nonsignificantly different OS (P=0.369). (3) In the chemotherapy group, patients with PFS<5 months exhibited longer 2(nd) PFS than those with PFS ≥ 5 months in the initial TKI treatment (3 months vs. 2 months, P=0.039). (4) In the chemotherapy group, patients treated with paclitaxel-containing regimen showed longer 2(nd) PFS than those treated with non-paclitaxel regimen (5 months vs. 2.3 months, P=0.043).

Conclusions: Patients with PFS≥7 months or <5 months under the initial TKI treatment potentially benefit from the 2(nd) TKI treatment or chemotherapy immediately after failure of the non-first line TKIs. The paclitaxel-containing regimen may improve the 2(nd) PFS. However, more patient samples are urgently needed to validate these findings.

No MeSH data available.


Related in: MedlinePlus

The OS of the 2nd TKI and chemotherapy groups immediately after the failure of initial TKI treatment.
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f1: The OS of the 2nd TKI and chemotherapy groups immediately after the failure of initial TKI treatment.

Mentions: Seventy-two patients were enrolled in the current study, 21 of whom were treated with 2nd TKIs, and the remaining patients accepted chemotherapy immediately after failure of the initial non-first line TKI treatment. All the baseline or prognostic characteristics, including gender, age, surgery history, radiotherapy history, pathological type, staging of disease, smoking history, responses, and so on, were evaluated prior to comparison of results. Most of these characteristics were re-evaluated in the different groups (Table 1). All characteristics were balanced, except that more male patients were enrolled in the chemotherapy group (P=0.001). There were nonsignificant differences between the 2nd response rates (PR/SD/PD) to the 2nd TKIs or chemotherapy of the two groups. The 2nd PFS and OS were compared in the two groups, which were three months versus three months (P=0.833) and 35.7 months versus 25.3 months (P=0.369), in the 2nd TKIs and chemotherapy groups, respectively. Neither the difference in the 2nd PFS nor OS between the two groups was significant. The OS values of the two groups are shown in Figure 1.


Initial Progression-Free Survival after Non-First Line TKIs Therapy Potentially Guides Immediate Treatment after Its Failure in Advanced Non-Small Cell Lung Cancer.

Wang F, Guo GF, Qiu HJ, He WZ, Zhou FF, Chen XX, Hu PL, Zhang B, Yin CX, Zhang L, Xia LP - Cancer Biol Med (2012)

The OS of the 2nd TKI and chemotherapy groups immediately after the failure of initial TKI treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3643642&req=5

f1: The OS of the 2nd TKI and chemotherapy groups immediately after the failure of initial TKI treatment.
Mentions: Seventy-two patients were enrolled in the current study, 21 of whom were treated with 2nd TKIs, and the remaining patients accepted chemotherapy immediately after failure of the initial non-first line TKI treatment. All the baseline or prognostic characteristics, including gender, age, surgery history, radiotherapy history, pathological type, staging of disease, smoking history, responses, and so on, were evaluated prior to comparison of results. Most of these characteristics were re-evaluated in the different groups (Table 1). All characteristics were balanced, except that more male patients were enrolled in the chemotherapy group (P=0.001). There were nonsignificant differences between the 2nd response rates (PR/SD/PD) to the 2nd TKIs or chemotherapy of the two groups. The 2nd PFS and OS were compared in the two groups, which were three months versus three months (P=0.833) and 35.7 months versus 25.3 months (P=0.369), in the 2nd TKIs and chemotherapy groups, respectively. Neither the difference in the 2nd PFS nor OS between the two groups was significant. The OS values of the two groups are shown in Figure 1.

Bottom Line: The standard therapy after failure of the initial non-first line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment in advanced non-small cell lung cancer (NSCLC) has not yet been established.The paclitaxel-containing regimen may improve the 2(nd) PFS.However, more patient samples are urgently needed to validate these findings.

View Article: PubMed Central - PubMed

Affiliation: State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; VIP Region, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.

ABSTRACT

Objective: The standard therapy after failure of the initial non-first line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment in advanced non-small cell lung cancer (NSCLC) has not yet been established. The aim of the current study was to identify whether the 2(nd) TKI treatment or chemotherapy (paclitaxel-containing or non-paclitaxel regimen) is the appropriate treatment for patients with NSCLC based on the efficacy of the initial TKIs.

Methods: Seventy-two advanced NSCLC patients who had accepted 2(nd) TKIs or chemotherapy immediately after failure of the initial TKIs in non-first line setting from May 1, 2004 to January 31, 2010 at the Sun Yat-sen University Cancer Center were enrolled. The primary endpoint [2(nd) progression-free survival (PFS)] and the second endpoint [overall survival (OS)] were compared among the 2(nd) TKI and chemotherapy groups as well as their subgroups.

Results: (1) Twenty-one patients were treated with 2(nd) TKIs, and 51 patients were administered chemotherapy after failure of the initial non-first line TKI treatment. There was nonsignificant difference in the responses (P=0.900) [2(nd) PFS (P=0.833) and OS (P=0.369)] between the 2(nd) TKI and chemotherapy groups. (2) In the 2(nd) TKI group, 9 patients exhibited PFS≥7 months. The initial TKI treatment group exhibited a longer 2(nd) PFS than the other 12 patients with an initial PFS<7 months (7 months vs. 2 months, P=0.019). However, these groups had nonsignificantly different OS (P=0.369). (3) In the chemotherapy group, patients with PFS<5 months exhibited longer 2(nd) PFS than those with PFS ≥ 5 months in the initial TKI treatment (3 months vs. 2 months, P=0.039). (4) In the chemotherapy group, patients treated with paclitaxel-containing regimen showed longer 2(nd) PFS than those treated with non-paclitaxel regimen (5 months vs. 2.3 months, P=0.043).

Conclusions: Patients with PFS≥7 months or <5 months under the initial TKI treatment potentially benefit from the 2(nd) TKI treatment or chemotherapy immediately after failure of the non-first line TKIs. The paclitaxel-containing regimen may improve the 2(nd) PFS. However, more patient samples are urgently needed to validate these findings.

No MeSH data available.


Related in: MedlinePlus