Post-Progression Survival in Patients with Non-Small Cell Lung Cancer with Clinically Acquired Resistance to Gefitinib.
10.3346/jkms.2013.28.11.1595
- Author:
Hyojeong KIM
1
;
Tak YUN
;
Young Joo LEE
;
Ji Youn HAN
;
Heung Tae KIM
;
Geon Kook LEE
Author Information
1. Department of Hemato-oncology, Pusan National University Hospital, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Carcinoma, Non-Small-Cell Lung;
Gefitinib;
Survival;
Pemetrexed
- MeSH:
Adenocarcinoma/drug therapy/*mortality;
Adult;
Aged;
Aged, 80 and over;
Antineoplastic Agents/therapeutic use;
Carcinoma, Non-Small-Cell Lung/drug therapy/*mortality;
Disease-Free Survival;
Drug Resistance, Neoplasm;
Female;
Glutamates/*therapeutic use;
Guanine/*analogs & derivatives/therapeutic use;
Humans;
Lung Neoplasms/drug therapy/*mortality;
Male;
Middle Aged;
Protein Kinase Inhibitors/*therapeutic use;
Quinazolines/*therapeutic use;
Retrospective Studies;
Survival;
Treatment Outcome
- From:Journal of Korean Medical Science
2013;28(11):1595-1602
- CountryRepublic of Korea
- Language:English
-
Abstract:
Most patients with tyrosine kinase inhibitor (TKI)-sensitive non-small cell lung cancer (NSCLC) eventually develop acquired resistance to TKIs. Factors that affect TKI-sensitive patient survival after progression during TKI treatment remain unknown. We attempted to identify factors that affected post-progression survival. We retrospectively reviewed 81 advanced NSCLC patients with disease progression following tumor response and durable (> or = 6 months) disease stabilization with first-line or second-line gefitinib. Post-progression survival (PPS) and characteristics were investigated and compared in patients who did (n = 16) and did not (n = 65) resume TKIs. Most patients were female never-smokers with adenocarcinoma. Median overall PPS was 10.3 months (95% confidence interval [CI], 7.458-13.142). Age, gender, smoking history, histology, Eastern Cooperative Oncology Group performance status at gefitinib initiation, initial stage, and platinum-based chemotherapy after gefitinib were not significant predictors of PPS. Pemetrexed use after gefitinib significantly improved PPS (18.5 vs 8.6 months; hazard ratio [HR], 0.45; P = 0.008). Gefitinib reuse tended to lengthen PPS but was insignificant in multivariate analysis (27.4 vs 8.8 months; HR, 0.53; P = 0.095). NSCLC patients assumed to have clinically acquired resistance to TKIs had relatively long PPS. TKIs reuse or pemetrexed use after progression with gefitinib may improve PPS.
