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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 < 5 months and ≥ 5 months in initial TKIs treatment in the chemotherapy group.
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f3: The 2nd PFS of patients with PFS < 5 months and ≥ 5 months in initial TKIs treatment in the chemotherapy group.

Mentions: The 51 patients in the chemotherapy group were classified based on the PFS values after the initial TKIs that are more than or equal to 5 months (29 patients) and less than 5 months (22 patients), and could be classified as patients who accepted paclitaxel-containing regimen chemotherapy (14 patients) or with non-paclitaxel regimen chemotherapy (37 patients). These groups had balanced characteristics, except that more patients were enrolled in the non-paclitaxel group with a history of radiotherapy (P=0.037) (Table 1). The response rates between the 2 subgroups were nonsignificantly different. Patients with PFS < 5 months showed longer 2nd PFS than patients with PFS ≥ 5 months after the initial TKIs in the chemotherapy group (3 months vs. 2 months, P=0.039) (Figure 3). However, OS between the 2 subgroups was nonsignificantly different (23.5 months vs. 33.0 months, P=0.465). In the chemotherapy group, patients who received paclitaxel-containing regimen showed a longer 2nd PFS than patients treated with non-paclitaxel regimen and the 2nd PFS were 5 months and 2.3 months (P=0.043), respectively (Figure 4). The OS between the two subgroups was nonsignificantly different (35.7 months vs. 23.6 months, P=0.578).


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 < 5 months and ≥ 5 months in initial TKIs treatment in the chemotherapy group.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f3: The 2nd PFS of patients with PFS < 5 months and ≥ 5 months in initial TKIs treatment in the chemotherapy group.
Mentions: The 51 patients in the chemotherapy group were classified based on the PFS values after the initial TKIs that are more than or equal to 5 months (29 patients) and less than 5 months (22 patients), and could be classified as patients who accepted paclitaxel-containing regimen chemotherapy (14 patients) or with non-paclitaxel regimen chemotherapy (37 patients). These groups had balanced characteristics, except that more patients were enrolled in the non-paclitaxel group with a history of radiotherapy (P=0.037) (Table 1). The response rates between the 2 subgroups were nonsignificantly different. Patients with PFS < 5 months showed longer 2nd PFS than patients with PFS ≥ 5 months after the initial TKIs in the chemotherapy group (3 months vs. 2 months, P=0.039) (Figure 3). However, OS between the 2 subgroups was nonsignificantly different (23.5 months vs. 33.0 months, P=0.465). In the chemotherapy group, patients who received paclitaxel-containing regimen showed a longer 2nd PFS than patients treated with non-paclitaxel regimen and the 2nd PFS were 5 months and 2.3 months (P=0.043), respectively (Figure 4). The OS between the two subgroups was nonsignificantly different (35.7 months vs. 23.6 months, P=0.578).

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