Outcome of non-small cell lung cancer in females with gefitinib therapy: An experience from eastern India.

Abstract

e18043 Background: Non-small cell lung carcinoma is usually an incurable disease with average overall survival of 7-9 months. But studies in recent years have shown that adenocarcinoma in nonsmokers with epidermal growth factor receptor (EGFR) positivity has shown disease control for longer duration. Female patients with adenocarcinoma where EGFR is positive show higher response rate with EGFR blocker. In eastern India, lung cancer contributes 21.3% of all cancers and female lung cancer contributes about 20% of them. The aim of our study was to see the age at diagnosis, histological type, EGFR status, smoking status and the response rate with Gefitinib, an EGFR tyrosine kinase inhibitor, for the female patients with carcinoma of lung. Methods: We randomly selected 50 female lung cancer patients, who had not previously received chemotherapy, during the period from November, 2006 to November, 2011. The mean age group at diagnosis was 55 years (range 26-85 years). 48 patients (96%) never had smoking habit, 2 (4%) were active smokers and the rest were passive smokers. Results: Twenty six (52%) patients had histological type of adenocarcinoma, 18 (36%) had squamas cell carcinoma, 4 were poorly differentiated and 2 (4%) had large cell carcinoma. Trucut biopsy showed EGFR positivity in 22 patients. All patients were started with single agent Gefitinib therapy at least for 6 months; after that according to response rate, same dose was continued. If there were progression of the disease, they were switched over to other chemotherapeutic agents. The median follow up was 1.5 years; the progression free survival (PFS) was seen in 19 (38%) patients. Adenocarcinoma patients with EGFR positivity had significantly higher PFS than those with non-adenocarcinoma and EGFR negative status. There was no difference of response rate between smokers and nonsmokers (never-smokers). Older patients showed higher response rates. Conclusions: Our data suggested that older patients with adenocarcinoma and EGFR positivity had long term progression free survival. So in developing countries like ours, where molecular diagnosis is not feasible many a times, this result might help clinicians to select a beneficial subgroup in female lung cancer patients.

A study of incidence of EGFR mutations in non-smoker adenocarcinoma of the lung: disparity between north and south indian patients

“…There have been very few studies involving Indian lung cancer patients response to tyrosine kinase inhibitors [27,28] & these studies showed some benefit of using TKIs. These studies didn't include the genetic evaluations of the tumour samples before initiation of the anti-EGFR treatment & therefore those results were based on patient population that has not been selected using genetic evaluations of the tumor samples.…”