Predictive Factors for Switched EGFR-TKI Retreatment in Patients with EGFR-Mutant Non-Small Cell Lung Cancer.
10.4046/trd.2017.80.2.187
- Author:
Byoung Soo KWON
1
;
Ji Hyun PARK
;
Woo Sung KIM
;
Joon Seon SONG
;
Chang Min CHOI
;
Jin Kyung RHO
;
Jae Cheol LEE
Author Information
1. Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Carcinoma, Non-Small-Cell Lung;
Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor;
Retreatment;
Predictive
- MeSH:
Carcinoma, Non-Small-Cell Lung*;
Disease-Free Survival;
Erlotinib Hydrochloride;
Exons;
Humans;
Medical Records;
Protein-Tyrosine Kinases;
Receptor, Epidermal Growth Factor;
Retreatment*;
Retrospective Studies;
Salvage Therapy;
Treatment Failure
- From:Tuberculosis and Respiratory Diseases
2017;80(2):187-193
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Third-generation tyrosine kinase inhibitors of the epidermal growth factor receptor (EGFR-TKIs) have proved efficacious in treating non-small cell lung cancer (NSCLC) patients with acquired resistance resulting from the T790M mutation. However, since almost 50% patients with the acquired resistance do not harbor the T790M mutation, retreatment with first- or second-generation EGFR-TKIs may be a more viable therapeutic option. Here, we identified positive response predictors to retreatment, in patients who switched to a different EGFR-TKI, following initial treatment failure. METHODS: This study retrospectively reviewed the medical records of 42 NSCLC patients with EGFR mutations, whose cancers had progressed following initial treatment with gefitinib or erlotinib, and who had switched to a different first-generation EGFR-TKI during subsequent retreatment. To identify high response rate predictors in the changed EGFR-TKI retreatment, we analyzed the relationship between clinical and demographic parameters, and positive clinical outcomes, following retreatment with EGFR-TKI. RESULTS: Overall, 30 (71.4%) patients received gefitinib and 12 (28.6%) patients received erlotinib as their first EGFR-TKI treatment. Following retreatment with a different EGFR-TKI, the overall response and disease control rates were 21.4% and 64.3%, respectively. There was no significant association between their overall responses. The median progression-free survival (PFS) after retreatment was 2.0 months. However, PFS was significantly longer in patients whose time to progression was ≥10 months following initial EGFR-TKI treatment, who had a mutation of exon 19, or whose treatment interval was <90 days. CONCLUSION: In patients with acquired resistance to initial EGFR-TKI therapy, switched EGFR-TKI retreatment may be a salvage therapy for individuals possessing positive retreatment response predictors.
