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

Kuwako, Tomohito; Imai, Hisao; Masuda, Tomomi; Miura, Yoshiko; Seki, Kaori; Yoshino, Reiko; Kaira, Kyoichi; Utsugi, Mitsuyoshi; Shimizu, Kimihiro; Sunaga, Noriaki; Tomizawa, Yoshio; Ishihara, Shinichi; Ishizuka, Takao; Mogi, Akira; Hisada, Takeshi; Minato, Koichi; Takise, Atsushi; Saito, Ryusei; Yamada, Masanobu

doi:10.1007/s00280-015-2841-5

Cited by 21 publications

(13 citation statements)

References 25 publications

(36 reference statements)

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“…For elderly patients with NSCLC harboring EGFR mutations, first-line gefitinib and erlotinib also provide a high response rate (RR) and prolonged survival [10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of Post-Progression Survival on Overall Survival in Elderly Patients with Non-Small-Cell Lung Cancer Harboring Sensitive EGFR Mutations Treated with First-Line EGFR Tyrosine Kinase Inhibitors

et al. 2018

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Background/Aims: More than 50% of patients with lung cancer are aged > 65 years, and non-small-cell lung cancer (NSCLC) accounts for 85% of all cases of lung cancer among both elderly and adult patients. Subsequent therapies confound the capability to discern the effect of first-line chemotherapy on overall survival (OS). Therefore, using individual-level data, our study aimed to determine the relationships of progression-free survival (PFS) and post-progression survival (PPS) with OS after first-line epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) treatment in elderly patients with NSCLC harboring sensitive EGFR mutations. Methods: Between April 2008 and December 2015, we analyzed 68 elderly patients with NSCLC harboring sensitive EGFR mutations and treated with first-line EGFR-TKI. The relationships of PFS and PPS with OS were analyzed at an individual level. Results: Linear regression analysis showed that PPS was more closely associated with OS (R² = 0.54) than PFS was (R² = 0.48). Best response at first-line treatment, performance status at the end of first-line treatment, and administration of EGFR-TKI rechallenge were significantly correlated with PPS. Conclusions: PPS has a stronger impact on OS than PFS does in elderly patients with NSCLC harboring sensitive EGFR mutations and treated with first-line EGFR-TKI. These results indicate that OS in this patient population may be influenced by treatments subsequent to first-line chemotherapy; however, this remains to be verified in prospective studies.

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“…For elderly patients with NSCLC harboring EGFR mutations, first-line gefitinib and erlotinib also provide a high response rate (RR) and prolonged survival [10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Clinical Impact of Post-Progression Survival on Overall Survival in Elderly Patients with Non-Small-Cell Lung Cancer Harboring Sensitive EGFR Mutations Treated with First-Line EGFR Tyrosine Kinase Inhibitors

et al. 2018

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“…Specifically, epidermal growth factor receptor (EGFR) mutations, such as exon 19 deletion and L858R point mutation, are well recognized as driver mutations and promising predictors of the efficacy of EGFR tyrosine kinase inhibitors (TKIs), such as gefitinib, erlotinib, and afatinib, in NSCLC patients harboring EGFR mutations [3][4][5][6][7]. In addition, EGFR-TKIs are recommended for elderly people [8][9][10] and they are effective regardless of the treatment timing in patients with NSCLC harboring EGFR mutations [11,12]. Recently, a large cohort study reported that gefitinib therapy resulted in a 5-year survival rate of approximately 20% in NSCLC patients harboring…”

Section: Introductionmentioning

confidence: 99%

Impact of EGFR-Tyrosine Kinase Inhibitors on Postoperative Recurrent Non-Small-Cell Lung Cancer Harboring EGFR Mutations

et al. 2017

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Background: It is unclear whether there is a difference in the efficacy of treatment by epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) between patients with postoperative recurrent non-small-cell lung cancer (NSCLC) and those with stage IV NSCLC harboring EGFR mutations. Patients and Methods: The records of NSCLC patients harboring EGFR mutations who were treated with gefitinib or erlotinib were retrospectively reviewed, and the treatment outcomes were evaluated. Moreover, we performed an immunohistochemical analysis of PD-L1 expression in tumor lesions of the postoperative recurrence group. Results: In 205 patients, both the progression-free survival (PFS) time (9.4 vs. 16.9 months) and the median survival time (24.7 vs. 37.4 months) were significantly longer in the postoperative group than in the stage IV group. Additionally, multivariate analysis identified that postoperative recurrence was an independent predictor of PFS and overall survival, as were performance status and smoking status. The PFS durations were 15.7 and 16.6 months for the high- and low-PD-L1 expression groups, respectively, and no significant difference was observed (P = 0.73). Conclusions: The findings of this study provide a valuable rationale for considering postoperative recurrence as a predictive factor for favorable PFS and overall survival in patients with NSCLC harboring activating EGFR mutations who receive EGFR-TKIs.

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“…EGFR-TKIs could prolong PFS, improve ORR and QoL, yet they have many side-effects, such as rash and diarrhea. [ 48 , 49 ] Taxanes also have several AEs: gastrointestinal reaction, alopecia, and hematological toxicity, particularly grade 3/4 leukopenia and neutropenia which tended to be more frequent after treatment with taxanes. [ 50 , 51 ] In the meta-analysis of this study, except for diarrhea and rash, there was a slightly worse trend toward EGFR-TKIs compared with taxanes.…”

Section: Discussionmentioning

confidence: 99%

EGFR-TKIs versus taxanes agents in therapy for nonsmall-cell lung cancer patients

Zhang

Niu³

et al. 2016

Medicine

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

Abstract: First-line gefitinib could be a preferable standard treatment in elderly patients with advanced NSCLC harboring sensitive EGFR mutations.

Cited by 21 publications

References 25 publications

Clinical Impact of Post-Progression Survival on Overall Survival in Elderly Patients with Non-Small-Cell Lung Cancer Harboring Sensitive EGFR Mutations Treated with First-Line EGFR Tyrosine Kinase Inhibitors

Clinical Impact of Post-Progression Survival on Overall Survival in Elderly Patients with Non-Small-Cell Lung Cancer Harboring Sensitive EGFR Mutations Treated with First-Line EGFR Tyrosine Kinase Inhibitors

Impact of EGFR-Tyrosine Kinase Inhibitors on Postoperative Recurrent Non-Small-Cell Lung Cancer Harboring EGFR Mutations

EGFR-TKIs versus taxanes agents in therapy for nonsmall-cell lung cancer patients

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