BACKGROUND: Gefitinib and erlotinib, small-molecule kinase inhibitors that block epidermal growth factor receptor (EGFR) signaling, have demonstrated a dramatic response rate and prolonged progression-free survival (PFS) in patients harboring an activating EGFR mutation. We compared the clinical outcomes in gefitinib- and erlotinib-treated patients harboring EGFR mutations who had recurrent or metastatic non-small-cell lung cancer (NSCLC). METHODS: A total of 375 patients with recurrent or metastatic stage IIIB/IV NSCLC, who had either exon 19 deletion or the L858R mutation in exon 21, and had received either gefitinib (n = 228) or erlotinib (n = 147), were included in the study. A matched-pair case-control study design was implemented in the analysis, where 121 pairs of gefitinib-treated and erlotinib-treated patients were matched according to sex, smoking history, Eastern Cooperative Oncology Group performance status, and types of EGFR mutation. RESULTS: The median age of all patients was 58 years (range, 30-84), and more than half of patients had never been smokers (63.6%). Most patients had adenocarcinoma (98.3%) and good Eastern Cooperative Oncology Group performance status (0, 1) (90.9%). The median number of cycles of EGFR tyrosine kinase inhibitor (TKI) treatment was 12.7 in the gefitinib group and 10.8 in the erlotinib group. Of the 242 patients, 63 (26%) received EGFR TKI as first-line therapy. The overall response rates and disease control rates in the gefitinib- or erlotinib-treated groups were 76.9% versus 74.4% (p = 0.575) and 90.1% versus 86.8%, respectively (p = 0.305). There was no statistically significant difference with regard to PFS (median, 11.7 versus 9.6; p = 0.056) between the gefitinib- and erlotinib-treated groups. For patients receiving EGFR TKI as the first-line treatment, there was no significant difference between the two treatment groups in overall response rates (76.7% and 90.0%) (p = 0.431) and median PFS (11.7 versus 14.5 months) (p = 0.507). CONCLUSION: In NSCLC patients harboring EGFR mutation, treatment with gefitinib and erlotinib resulted in similar effectiveness.
BACKGROUND:Gefitinib and erlotinib, small-molecule kinase inhibitors that block epidermal growth factor receptor (EGFR) signaling, have demonstrated a dramatic response rate and prolonged progression-free survival (PFS) in patients harboring an activating EGFR mutation. We compared the clinical outcomes in gefitinib- and erlotinib-treated patients harboring EGFR mutations who had recurrent or metastatic non-small-cell lung cancer (NSCLC). METHODS: A total of 375 patients with recurrent or metastatic stage IIIB/IV NSCLC, who had either exon 19 deletion or the L858R mutation in exon 21, and had received either gefitinib (n = 228) or erlotinib (n = 147), were included in the study. A matched-pair case-control study design was implemented in the analysis, where 121 pairs of gefitinib-treated and erlotinib-treated patients were matched according to sex, smoking history, Eastern Cooperative Oncology Group performance status, and types of EGFR mutation. RESULTS: The median age of all patients was 58 years (range, 30-84), and more than half of patients had never been smokers (63.6%). Most patients had adenocarcinoma (98.3%) and good Eastern Cooperative Oncology Group performance status (0, 1) (90.9%). The median number of cycles of EGFR tyrosine kinase inhibitor (TKI) treatment was 12.7 in the gefitinib group and 10.8 in the erlotinib group. Of the 242 patients, 63 (26%) received EGFR TKI as first-line therapy. The overall response rates and disease control rates in the gefitinib- or erlotinib-treated groups were 76.9% versus 74.4% (p = 0.575) and 90.1% versus 86.8%, respectively (p = 0.305). There was no statistically significant difference with regard to PFS (median, 11.7 versus 9.6; p = 0.056) between the gefitinib- and erlotinib-treated groups. For patients receiving EGFR TKI as the first-line treatment, there was no significant difference between the two treatment groups in overall response rates (76.7% and 90.0%) (p = 0.431) and median PFS (11.7 versus 14.5 months) (p = 0.507). CONCLUSION: In NSCLCpatients harboring EGFR mutation, treatment with gefitinib and erlotinib resulted in similar effectiveness.
Authors: Pawel Krawczyk; Dariusz M Kowalski; Rodryg Ramlau; Ewa Kalinka-Warzocha; Kinga Winiarczyk; Katarzyna Stencel; Tomasz Powrózek; Katarzyna Reszka; Kamila Wojas-Krawczyk; Maciej Bryl; Magdalena Wójcik-Superczyńska; Maciej Głogowski; Aleksander Barinow-Wojewódzki; Janusz Milanowski; Maciej Krzakowski Journal: Oncol Lett Date: 2017-04-03 Impact factor: 2.967
Authors: Amit Jain; Cindy Lim; Eugene MingJin Gan; David Zhihao Ng; Quan Sing Ng; Mei Kim Ang; Angela Takano; Kian Sing Chan; Wu Meng Tan; Ravindran Kanesvaran; Chee Keong Toh; Chian Min Loo; Anne Ann Ling Hsu; Anantham Devanand; Chong Hee Lim; Heng Nung Koong; Tina Koh; Kam Weng Fong; Swee Peng Yap; Su Woon Kim; Balram Chowbay; Lynette Oon; Kiat Hon Lim; Wan Teck Lim; Eng Huat Tan; Daniel Shao Weng Tan Journal: PLoS One Date: 2015-05-08 Impact factor: 3.240
Authors: Alissa R Verone-Boyle; Suzanne Shoemaker; Kristopher Attwood; Carl D Morrison; Andrew J Makowski; Sebastiano Battaglia; Pamela A Hershberger Journal: Oncotarget Date: 2016-01-05