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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 2nd PFS of patients with PFS more than or equal to 7 months and less than 7 months after the initial TKI treatment in 2nd TKIs group.
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f2: The 2nd PFS of patients with PFS more than or equal to 7 months and less than 7 months after the initial TKI treatment in 2nd TKIs group.

Mentions: Of the 21 patients in the 2nd TKI group, 17 patients shifted from gefitinib to erlotinib treatment, whereas the remaining patients were given gefitinib continuously after its failure. These patients were classified based on the PFS values under the initial TKIs that are more than or equal to 7 months (9 patients) and less than 7 months (12 patients). The two subgroups have balanced characteristics (Table 1). The nonsignificantly different response rates between the two subgroups (P=0.171) are listed in Table 1. Only the 2nd PFS between the two subgroups were significantly different (7 months vs. 2 months, P=0.019) (Figure 2). The OS between the two groups was nonsignificantly different (35.6 months vs. 29.3 months, P=0.369).


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 2nd PFS of patients with PFS more than or equal to 7 months and less than 7 months after the initial TKI treatment in 2nd TKIs group.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f2: The 2nd PFS of patients with PFS more than or equal to 7 months and less than 7 months after the initial TKI treatment in 2nd TKIs group.
Mentions: Of the 21 patients in the 2nd TKI group, 17 patients shifted from gefitinib to erlotinib treatment, whereas the remaining patients were given gefitinib continuously after its failure. These patients were classified based on the PFS values under the initial TKIs that are more than or equal to 7 months (9 patients) and less than 7 months (12 patients). The two subgroups have balanced characteristics (Table 1). The nonsignificantly different response rates between the two subgroups (P=0.171) are listed in Table 1. Only the 2nd PFS between the two subgroups were significantly different (7 months vs. 2 months, P=0.019) (Figure 2). The OS between the two groups was nonsignificantly different (35.6 months vs. 29.3 months, P=0.369).

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