Federico Cappuzzo1, Alessandro Morabito2, Nicola Normanno3, Paolo Bidoli4, Alessandro Del Conte5, Laura Giannetta6, Agnese Montanino7, Francesca Mazzoni8, Roberta Buosi9, Marco Angelo Burgio10, Giulio Cerea11, Rita Chiari12, Diego Cortinovis13, Giovanna Finocchiaro14, Luisa Foltran15, Maria Rita Migliorino16, Marcello Tiseo17, Silvia Ferrari18, Filippo De Marinis19. 1. Medical Oncology Department, Istituto Toscano Tumori, Ospedale Civile, Viale Alfieri 36, 57100 Livorno, Italy. Electronic address: f.cappuzzo@googlemail.com. 2. Thoracic Medical Oncology, Istituto Nazionale Tumori "Fondazione G Pascale"-IRCCS, Via Semmola, 80131 Naples, Italy. Electronic address: a.morabito@istitutotumori.na.it. 3. Cell Biology & Biotherapy Unit, Istituto Nazionale Tumori "Fondazione G Pascale"-IRCCS, Via Semmola, 80131 Naples, Italy. Electronic address: n.normanno@istitutotumori.na.it. 4. Department of Oncology, San Gerardo Hospital, Monza, Via Pergolesi 33, 20900 Monza, Italy. Electronic address: p.bidoli@hsgerardo.org. 5. Medical Oncology, Azienda per l'Assistenza Sanitaria No. 5 (AAS5) - Friuli Occidentale - Presidio Ospedaliero di Pordenone, Via Montereale 24, 33170 Pordenone, Italy. Electronic address: alessandro.delconte@aas5.sanita.fvg.it. 6. Oncologia Falck, Division of Medical Oncology, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. Electronic address: laura.giannetta@ospedaleniguarda.it. 7. Thoracic Medical Oncology, Istituto Nazionale Tumori "Fondazione G Pascale"-IRCCS, Via Semmola, 80131 Naples, Italy. Electronic address: a.montanino@istitutotumori.na.it. 8. Medical Oncology, University Hospital Careggi, L. go Brambilla 3, 50134 Florence, Italy. Electronic address: francescamazzoni@hotmail.com. 9. Division of Oncology, Department of Translational Medicine, University of Eastern Piedmont "Amedeo Avogadro", 28100 Novara, Italy. Electronic address: r.buosi@maggioreosp.novara.it. 10. Department of Medical Oncology, IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST), Meldola, Italy. Electronic address: marco.burgio@irst.emr.it. 11. Oncologia Falck, Division of Medical Oncology, Niguarda Ca' Granda Hospital, Piazza Ospedale Maggiore 3, 20162 Milan, Italy. Electronic address: giulio.cerea@ospedaleniguarda.it. 12. Department of Medical Oncology, "Santa Maria della Misericordia" Hospital, Azienda Ospedaliera di Perugia, 06132 Perugia, Italy. Electronic address: rita.chiari@ospedale.perugia.it. 13. Department of Oncology, San Gerardo Hospital, Monza, Via Pergolesi 33, 20900 Monza, Italy. Electronic address: d.cortinovis@hsgerardo.org. 14. Department of Medical Oncology, Istituto Clinico Humanitas IRCCS, Via Manzoni 56, 20089 Rozzano, Milan, Italy. Electronic address: giovanna.finocchiaro@cancercenter.humanitas.it. 15. Medical Oncology, Azienda per l'Assistenza Sanitaria No. 5 (AAS5) - Friuli Occidentale - Presidio Ospedaliero di Pordenone, Via Montereale 24, 33170 Pordenone, Italy. Electronic address: luisa.foltran@aas5.sanita.fvg.it. 16. Department of Thoracic Oncology, 1st Pulmonary Oncological Unit, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy. Electronic address: ritamigliorino@tiscali.it. 17. Division of Medical Oncology, University Hospital of Parma, Via Gramsci, 14, 43126 Parma, Italy. Electronic address: mtiseo@ao.pr.it. 18. AstraZeneca, Palazzo Ferraris, Via Ludovico il Moro 6/C, 20080 Basiglio, Milan, Italy. Electronic address: silvia.ferrari@astrazeneca.com. 19. Thoracic Oncology Division, Istituto Europeo di Oncologia (IEO), Via Ripamonti 435, 20141 Milan, Italy, Italy; Formerly Department of Thoracic Oncology, 1st Pulmonary Oncological Unit, Azienda Ospedaliera San Camillo-Forlanini, Rome, Italy. Electronic address: filippo.demarinis@ieo.it.
Abstract
OBJECTIVES: Although patients with advanced non-small cell lung cancer (NSCLC) and an activating epidermal growth factor receptor (EGFR) mutation benefit from the use of EGFR-tyrosine kinase inhibitors (TKI), most of them progress within 12 months from treatment start due to acquired resistance. In clinical practice, many physicians frequently offer these patients retreatment with EGFR-TKIs after a chemotherapy break, based on small or retrospective studies. MATERIALS AND METHODS: A phase II trial was conducted in patients with stage III/IV NSCLC, to assess the efficacy, safety and impact on quality of life (QoL) and disease-related symptoms of gefitinib rechallenge. Eligible patients had initially responded to first-line gefitinib and progressed after second-line chemotherapy. RESULTS: Of 61 enrolled patients, 73.8% were female, 100% had EGFR-mutated adenocarcinoma and 67.2% were never-smokers. Thirty-two (52.5%) patients obtained a clinical benefit, with 3 (4.9%) achieving a partial response and 29 (47.5%) having stable disease. Median progression-free survival was 2.8 months, overall survival 10.2 months and duration of gefitinib treatment 3.6 months. The most common all grade-adverse events were diarrhea (27.6%), nausea and/or vomiting (20.3%), rash (14.7%) and dyspnea (10.3%); no new toxicities were apparent. CONCLUSION: Findings from this study indicate that gefitinib rechallenge offers modest benefit and may be taken into consideration only for patients for whom no other treatment option exists.
OBJECTIVES: Although patients with advanced non-small cell lung cancer (NSCLC) and an activating epidermal growth factor receptor (EGFR) mutation benefit from the use of EGFR-tyrosine kinase inhibitors (TKI), most of them progress within 12 months from treatment start due to acquired resistance. In clinical practice, many physicians frequently offer these patients retreatment with EGFR-TKIs after a chemotherapy break, based on small or retrospective studies. MATERIALS AND METHODS: A phase II trial was conducted in patients with stage III/IV NSCLC, to assess the efficacy, safety and impact on quality of life (QoL) and disease-related symptoms of gefitinib rechallenge. Eligible patients had initially responded to first-line gefitinib and progressed after second-line chemotherapy. RESULTS: Of 61 enrolled patients, 73.8% were female, 100% had EGFR-mutated adenocarcinoma and 67.2% were never-smokers. Thirty-two (52.5%) patients obtained a clinical benefit, with 3 (4.9%) achieving a partial response and 29 (47.5%) having stable disease. Median progression-free survival was 2.8 months, overall survival 10.2 months and duration of gefitinib treatment 3.6 months. The most common all grade-adverse events were diarrhea (27.6%), nausea and/or vomiting (20.3%), rash (14.7%) and dyspnea (10.3%); no new toxicities were apparent. CONCLUSION: Findings from this study indicate that gefitinib rechallenge offers modest benefit and may be taken into consideration only for patients for whom no other treatment option exists.
Authors: L Paz-Ares; E-H Tan; K O'Byrne; L Zhang; V Hirsh; M Boyer; J C-H Yang; T Mok; K H Lee; S Lu; Y Shi; D H Lee; J Laskin; D-W Kim; S A Laurie; K Kölbeck; J Fan; N Dodd; A Märten; K Park Journal: Ann Oncol Date: 2017-02-01 Impact factor: 32.976
Authors: Lu Yang; Sheng Yang; Yutao Liu; Junling Li; Xingsheng Hu; Yalei Wang; Yan Zhang; Yan Wang Journal: Thorac Cancer Date: 2018-04-14 Impact factor: 3.500
Authors: Richard M Goldberg; Clara Montagut; Zev A Wainberg; Philippe Ronga; François Audhuy; Julien Taieb; Sebastian Stintzing; Salvatore Siena; Daniele Santini Journal: ESMO Open Date: 2018-05-05