Survival Outcomes in EGFR Mutation-Positive Lung Cancer Patients Treated with Gefitinib until or beyond Progression
| Autor: | Nikita M. Volkov, Kseniya V. Shelekhova, Alexandr O. Ivantsov, Elena V. Preobrazhenskaya, Michail M. Kramchaninov, Fedor V. Moiseyenko, Kseniya S. Kozyreva, Svetlana N. Aleksakhina, Aigul R. Venina, Natalia V. Mitiushkina, Aglaya G. Iyevleva, Vyacheslav A. Chubenko, Alexandr S. Zhuravlev, Evgeny N. Imyanitov, Vladimir M. Moiseyenko |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Male 0301 basic medicine Oncology Cancer Research medicine.medical_specialty Lung Neoplasms Antineoplastic Agents Disease Disease-Free Survival Russia 03 medical and health sciences 0302 clinical medicine Gefitinib Risk Factors Carcinoma Non-Small-Cell Lung Internal medicine Prevalence medicine Humans Genetic Predisposition to Disease heterocyclic compounds skin and connective tissue diseases Lung cancer neoplasms Aged Aged 80 and over integumentary system business.industry Hematology Middle Aged medicine.disease respiratory tract diseases Discontinuation ErbB Receptors Treatment Outcome 030104 developmental biology Egfr mutation 030220 oncology & carcinogenesis Mutation Disease Progression Quinazolines Female Neoplasm Recurrence Local business medicine.drug |
| Zdroj: | Oncology Research and Treatment. 39:605-614 |
| ISSN: | 2296-5262 2296-5270 |
| Popis: | Background: Discontinuation of gefitinib treatment is often accompanied by a disease flare. Some studies have demonstrated a benefit of the use of epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKI) beyond progression; however, long-term results of these investigations remain limited. Patients and Methods: We observed 70 patients with EGFR-mutated (EGFR-M+) non-small cell lung cancer (NSCLC) receiving single-agent gefitinib in a routine clinical setting; 56 patients were experiencing RECIST progression at the time of the analysis. Results: There was a significant increase (p = 0.00001) in overall survival (OS) in patients continuing on gefitinib beyond progression (n = 21; median duration of continued gefitinib use: 4.2 months; median OS: not reached; expected OS: 29.7 months) as compared to those who stopped gefitinib treatment upon disease progression (n = 35; median OS: 14.0 months). The association between extended gefitinib use and improved OS remained true in multivariate Cox regression analysis (hazard ratio = 4.49, 95% confidence interval 1.25-16.09; p = 0.021). Patient selection bias constitutes an essential limitation of this clinical observational study, given that patients with a more favorable disease course and/or high initial tumor sensitivity to TKI treatment were more likely to be considered for prolonged gefitinib use. Conclusion: This study confirms that continued administration of gefitinib beyond progression is a viable treatment option for some patients with EGFR-M+ NSCLC, in particular those who cannot be rescued by novel EGFR mutation-specific inhibitors such as osimertinib. |
| Databáze: | OpenAIRE |
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