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Effect of EGFR-TKI retreatment following chemotherapy for advanced non-small cell lung cancer patients who underwent EGFR-TKI.

Xia GH, Zeng Y, Fang Y, Yu SR, Wang L, Shi MQ, Sun WL, Huang XE, Chen J, Feng JF - Cancer Biol Med (2014)

Bottom Line: Of the 14 patients who received another EGFR-TKI, no patient in CR, 6 patients in PR, 6 patients in SD, and 2 patients in PD were observed.The DCR was 85.7%, and the mPFS was 9.5 months.Significant difference was found between the two groups in PFS but not in response rate or DCR.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Jiangsu Cancer Hospital, Nanjing 210009, China.

ABSTRACT

Objective: Non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR)-activating mutations have higher response rate and more prolonged survival following treatment with single-agent EGFR tyrosine kinase inhibitor (EGFR-TKI) compared with patients with wild-type EGFR. However, all patients treated with reversible inhibitors develop acquired resistance over time. The mechanisms of resistance are complicated. The lack of established therapeutic options for patients after a failed EGFR-TKI treatment poses a great challenge to physicians in managing this group of lung cancer patients. This study evaluates the influence of EGFR-TKI retreatment following chemotherapy after failure of initial EGFR-TKI within at least 6 months on NSCLC patients.

Methods: The data of 27 patients who experienced treatment failure from their initial use of EGFR-TKI within at least 6 months were analyzed. After chemotherapy, the patients were retreated with EGFR-TKI (gefitinib 250 mg qd or erlotinib 150 mg qd), and the tumor progression was observed. The patients were assessed for adverse events and response to therapy. Targeted tumor lesions were assessed with CT scan.

Results: Of the 27 patients who received EGFR-TKI retreatment, 1 (3.7%) patient was observed in complete response (CR), 8 (29.6%) patients in partial response (PR), 14 (51.9%) patients in stable disease (SD), and 4 (14.8%) patients in progressive disease (PD). The disease control rate (DCR) was 85.2% (95% CI: 62%-94%). The median progression-free survival (mPFS) was 6 months (95% CI: 1-29). Of the 13 patients who received the same EGFR-TKI, 1 patient in CR, 3 patients in PR, 8 patients in SD, and 2 patients in PD were observed. The DCR was 84.6%, and the mPFS was 5 months. Of the 14 patients who received another EGFR-TKI, no patient in CR, 6 patients in PR, 6 patients in SD, and 2 patients in PD were observed. The DCR was 85.7%, and the mPFS was 9.5 months. Significant difference was found between the two groups in PFS but not in response rate or DCR.

Conclusion: Retreatment of EGFR-TKIs can be considered an option after failure of chemotherapy for patients who were previously controlled by EGFR-TKI treatment.

No MeSH data available.


Related in: MedlinePlus

Comparison of EGFR-TKI retreatment in the disease-free survival with the same drug group (PFSs2) and the different drug group (PFSa2).
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f4: Comparison of EGFR-TKI retreatment in the disease-free survival with the same drug group (PFSs2) and the different drug group (PFSa2).

Mentions: Initial mPFS is 19 months, with 20 months in the same-drug group, and 11 months in the different-drug group. Thus, a significant difference exists between these two groups (P<0.05). This result indicates that initial mPFS in the same-drug group using EGFR-TKI was evidently longer than that in the different-drug group. The mPFS by reusing EGFR-TKI was 6 months, 5 months in the same-drug group, and 9.5 months in the different-drug group. Thus, a significant difference exists between the two groups (P<0.05). This result indicates that the mPFS by reusing EGFR-TKI in the different-drug group was evidently longer than that in the same-drug group. Moreover, the PFS of reusing the same EGFR-TKI was less than initial PFS, which was 42.8% (6/14). PFS of reusing another EGFR-TKI was more than initial PFS. The proportion of mPFS of retreatment to initial mPFS was 25% (5/20) for the same-drug group, whereas it was 86% (9.5/11) in the different-drug group (Figures 1,2,3,4). The interval of two applications of EGFR-TKI was 4-15 months. The median was 7 months.


Effect of EGFR-TKI retreatment following chemotherapy for advanced non-small cell lung cancer patients who underwent EGFR-TKI.

Xia GH, Zeng Y, Fang Y, Yu SR, Wang L, Shi MQ, Sun WL, Huang XE, Chen J, Feng JF - Cancer Biol Med (2014)

Comparison of EGFR-TKI retreatment in the disease-free survival with the same drug group (PFSs2) and the different drug group (PFSa2).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4296083&req=5

f4: Comparison of EGFR-TKI retreatment in the disease-free survival with the same drug group (PFSs2) and the different drug group (PFSa2).
Mentions: Initial mPFS is 19 months, with 20 months in the same-drug group, and 11 months in the different-drug group. Thus, a significant difference exists between these two groups (P<0.05). This result indicates that initial mPFS in the same-drug group using EGFR-TKI was evidently longer than that in the different-drug group. The mPFS by reusing EGFR-TKI was 6 months, 5 months in the same-drug group, and 9.5 months in the different-drug group. Thus, a significant difference exists between the two groups (P<0.05). This result indicates that the mPFS by reusing EGFR-TKI in the different-drug group was evidently longer than that in the same-drug group. Moreover, the PFS of reusing the same EGFR-TKI was less than initial PFS, which was 42.8% (6/14). PFS of reusing another EGFR-TKI was more than initial PFS. The proportion of mPFS of retreatment to initial mPFS was 25% (5/20) for the same-drug group, whereas it was 86% (9.5/11) in the different-drug group (Figures 1,2,3,4). The interval of two applications of EGFR-TKI was 4-15 months. The median was 7 months.

Bottom Line: Of the 14 patients who received another EGFR-TKI, no patient in CR, 6 patients in PR, 6 patients in SD, and 2 patients in PD were observed.The DCR was 85.7%, and the mPFS was 9.5 months.Significant difference was found between the two groups in PFS but not in response rate or DCR.

View Article: PubMed Central - PubMed

Affiliation: Department of Medical Oncology, Jiangsu Cancer Hospital, Nanjing 210009, China.

ABSTRACT

Objective: Non-small cell lung cancer (NSCLC) patients with epidermal growth factor receptor (EGFR)-activating mutations have higher response rate and more prolonged survival following treatment with single-agent EGFR tyrosine kinase inhibitor (EGFR-TKI) compared with patients with wild-type EGFR. However, all patients treated with reversible inhibitors develop acquired resistance over time. The mechanisms of resistance are complicated. The lack of established therapeutic options for patients after a failed EGFR-TKI treatment poses a great challenge to physicians in managing this group of lung cancer patients. This study evaluates the influence of EGFR-TKI retreatment following chemotherapy after failure of initial EGFR-TKI within at least 6 months on NSCLC patients.

Methods: The data of 27 patients who experienced treatment failure from their initial use of EGFR-TKI within at least 6 months were analyzed. After chemotherapy, the patients were retreated with EGFR-TKI (gefitinib 250 mg qd or erlotinib 150 mg qd), and the tumor progression was observed. The patients were assessed for adverse events and response to therapy. Targeted tumor lesions were assessed with CT scan.

Results: Of the 27 patients who received EGFR-TKI retreatment, 1 (3.7%) patient was observed in complete response (CR), 8 (29.6%) patients in partial response (PR), 14 (51.9%) patients in stable disease (SD), and 4 (14.8%) patients in progressive disease (PD). The disease control rate (DCR) was 85.2% (95% CI: 62%-94%). The median progression-free survival (mPFS) was 6 months (95% CI: 1-29). Of the 13 patients who received the same EGFR-TKI, 1 patient in CR, 3 patients in PR, 8 patients in SD, and 2 patients in PD were observed. The DCR was 84.6%, and the mPFS was 5 months. Of the 14 patients who received another EGFR-TKI, no patient in CR, 6 patients in PR, 6 patients in SD, and 2 patients in PD were observed. The DCR was 85.7%, and the mPFS was 9.5 months. Significant difference was found between the two groups in PFS but not in response rate or DCR.

Conclusion: Retreatment of EGFR-TKIs can be considered an option after failure of chemotherapy for patients who were previously controlled by EGFR-TKI treatment.

No MeSH data available.


Related in: MedlinePlus