Clinical outcomes in elderly patients administered gefitinib as first-line treatment in epidermal growth factor receptor-mutated non-small-cell lung cancer: retrospective analysis in a Nagano Lung Cancer Research Group Study

Abstract

ABSTRACT[214 words (do not exceed 250)]Purpose: The clinical efficacy and outcomes of gefitinib therapy as a first-line treatment for elderly patients with non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations were analyzed retrospectively. Patients and methods:We analyzed chemotherapy-naïve NSCLC patients aged 75 years or older who had EGFR mutations (exon 19 deletion mutation or L858R), who were initially treated with gefitinib (250 mg) once daily in Nagano Prefecture.Results: A total of 55 patients (16 men, 39 women) with a median age of 81.1 years (range: 75 -94 years) treated between April 2007 and July 2012, were analyzed. The overall response rate and disease control rate were 72.7% (95% confidence interval (CI); 59.5% -82.9%) and 92.7% (95% CI: 82.0% -97.6%), respectively. Median progression-free survival and overall survival from the start of gefitinib treatment were 13.8 months (CI: 9.9 -18.8 months) and 29.1 months (95% CI: 22.4 -not reached), respectively. Two-year survival rate was 59.5% (95% CI; 41.0% -78.8%). Major grade 3 toxicities were skin rash (1.8%) and increased levels of aspartate aminotransferase or alanine aminotransferase (7.3%). Conclusion:First-line treatment with gefitinib for elderly EGFR-mutated NSCLC patients was effective and well tolerated. The results suggest that first-line gefitinib should be considered as a preferable standard treatment in elderly patients with advanced NSCLC harboring EGFR mutations.

First-line gefitinib treatment in elderly patients (aged ≥75 years) with non-small cell lung cancer harboring EGFR mutations

“…We identified four prospective and two retrospective studies. However, patients of one prospective study [16] were included as patients of another retrospective study [21]; therefore, the prospective study was excluded from our compilation ( [17]. Based on the results of this compilation, we confirmed that the prevalence of female patients, adenocarcinoma, and non-smokers among elderly NSCLC patients was consistent with that reported previously [26].…”

“…Interestingly, several previous clinical trials have examined the efficacy of gefitinib as a first-line treatment for elderly patients with NSCLC harboring sensitive EGFR mutations [15][16][17][18][19][20][21]. Their results suggest that first-line gefitinib is preferable to standard therapy in elderly patients.…”

Current and Emerging Options in the Management of EGFR Mutation-Positive Non-Small-Cell Lung Cancer: Considerations in the Elderly

“…In 2013, Tateishi et al confirmed the strong activity and the favourable safety profile of gefitinib in a retrospective analysis among 55 chemotherapy-naïve EGFR mut? NSCLC patients aged 75 years or older [55].…”

Phase II study of erlotinib in elderly patients with non-small cell lung cancer harboring epidermal growth factor receptor mutations

“…However, these clinical trials were usually conducted only or mainly in healthy patients aged 75 years or younger. In elderly patients with advanced EGFR-mutated NSCLC, some reports [13][14][15] showed the efficacy and safety of gefitinib. However, to our knowledge, the antitumor effects and safety profiles of erlotinib focused on elderly patients have not been evaluated.…”