P2.23 First-Line Gefitinib in Epidermal Growth Factor Receptor Mutation-Positive (EGFR+) Non-Small Cell Lung Cancer (NSCLC) in an Israeli Cohort
| Autor: | Amir Onn, Haim Biran, Damien Urban, Raya Leibowitz-Amit, Daniel Keizman, Sayeh Ben-Arieh, Maya Gottfried, M. Mishaeli, N. Maimon |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Oncology
medicine.medical_specialty education.field_of_study biology business.industry Population non-small cell lung cancer (NSCLC) Retrospective cohort study Hematology medicine.disease Rash Gefitinib Internal medicine medicine biology.protein Epidermal growth factor receptor medicine.symptom business education Progressive disease Pharmacogenetics medicine.drug |
| Zdroj: | Annals of Oncology. 23:v29 |
| ISSN: | 0923-7534 |
| DOI: | 10.1016/s0923-7534(20)31346-6 |
| Popis: | Background Reported response rates (RR) to 1st line gefitinib in advanced EGFR+ NSCLC range from 55 % to over 70 %. The primary goal of this retrospective analysis was to study the efficacy of gefitinib in the first line treatment of EGFR+ advanced NSCLC patients in two Israeli tertiary hospitals. Method The clinical data of patients tested positive for EGFR mutations from theShebaMedicalCenterand theMeirHospitalsince the beginning of 2010 were included in the current retrospective analysis. Results EGFR mutations were identified in 20 % of patients evaluated, with 38 patients testing positive for mutations. EGFR mutations detected were: exon 19 deletions (55 %), exon 21 L858R point mutations (26 %), exon 21 Leu861Gln (11 %), exon 18 Ala719Gly (5 %) and other (3 %). Demographic details included: median age was 69 (range 45-85); 24 females (63 %); 23 never-smokers (61 %). Histological subtypes identified as EGFR+ were: 31 adenocarcinomas (81 %), 2 squamous cell carcinomas (5 %) and 5 of non-squamous origin. 26 patients were treated with first-line gefitinib. 85 % had an ECOG performance status of 0-2. Adverse events were generally mild and similar to published reports - 9 experienced grade 1-2 rash (34 %), 6 experienced grade 1-2 diarrhea (23 %) and one patient had grade 3 hypomagnesemia. 23 of these patients have been evaluated for treatment response. The best response according to the RECIST criteria was: 3 patients achieved a partial response (13 %), 10 achieved stable disease (43 %), and 10 had progressive disease (43 %). Median time to progression was 5 months and median overall survival was 12 months. Thus, in this current retrospective study of the Israeli population, our response rate, TTP and OS is significantly lower than expected. The null-hypothesis of a minimal 50 % response rate (as seen for other western populations) is rejected with a P value of 0·01 using a two-tailed chi-square test. Conclusion Albeit the small number of patients in this current retrospective study, the low rate of radiological response suggests that in our tested population, the actual response rate is significantly lower than reported in the literature. Epidemiologic, pharmacogenetic and/or molecular mechanisms of resistance need to be explored to explain these differences. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|