Skin rash and bronchoalveolar histology correlates with clinical benefit in patients treated with gefitinib as a therapy for previously treated advanced or metastatic non-small cell lung cancer

Dudek, Arkadiusz Z.; Kmak, Krzysztof Lesniewski; Koopmeiners, Joseph S.; Keshtgarpour, Mani

doi:10.1016/j.lungcan.2005.09.002

Cited by 54 publications

(25 citation statements)

References 41 publications

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“…However, our findings are in line with the result of a previous study that reported a low SUV at the time of diagnosis in a pathologic subtype of bronchioloalveloar carcinoma (27), another predictor of TKI responsiveness (20). Interestingly, we observed that the SUV of never-smokers was lower than that of smokers.…”

Section: Discussionsupporting

confidence: 93%

18F-Fluoro-2-Deoxy-Glucose Uptake Predicts Clinical Outcome in Patients with Gefitinib-Treated Non–Small Cell Lung Cancer

Na¹,

Byun²,

Kang³

et al. 2008

Clinical Cancer Research

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Purpose: To evaluate response and survival according to 18 F-fluoro-2-deoxy-glucose uptake at presentation in patients with gefitinib-treated non^small cell lung cancer. Experimental Design: We retrospectively analyzed 84 positron emission tomography/computed tomography findings. Patient characteristics, response rates, and survivals were evaluated according to the maximum standardized uptake value (SUV) of primary tumor. The cutoff value of SUVs was obtained from receiver operating characteristic analysis. Results: The response rate (RR) was higher for never-smokers (41%) than ever-smokers (9%; P = 0.001). Patients with adenocarcinoma showed higher RR than those with other tumor histopathology (35% versus 9%; P = 0.009). The SUV was significantly lower in patients who were never-smokers (P = 0.005), patients with adenocarcinoma (P < 0.001), and female patients (P = 0.017). Patients with a low SUV showed higher RR compared with those with a high SUV (53% versus 18%; P = 0.003). Prolonged progression-free survival was observed in patients with low SUVs compared with those with high SUVs (median, 33.1 weeks versus 8.6 weeks; P = 0.003). While controlling for performance status, smoking history, and pathology, the high SUV conferred unfavorable outcome (hazard ratio, 2.3; P = 0.012). In terms of overall survival, a low SUV was associated with favorable outcome in univariate analysis (P = 0.011). Patients with a low SUV showed prolonged survival in multivariate analysis (P = 0.043). Conclusions: These results suggest that low SUVs at presentation can predict favorable response and survival in gefitinib-treated non^small cell lung cancer patients.

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Section: Discussionsupporting

confidence: 93%

18F-Fluoro-2-Deoxy-Glucose Uptake Predicts Clinical Outcome in Patients with Gefitinib-Treated Non–Small Cell Lung Cancer

Na¹,

Byun²,

Kang³

et al. 2008

Clinical Cancer Research

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“…This finding was consistent with many previous reports [17,18,19]. One hundred seventy-one patients with skin rash of any grade were divided as follows: grade 1 (n = 101), grade 2 (n = 51), and grade 3 (n = 19).…”

Section: Discussionsupporting

confidence: 92%

Prognostic Model to Predict Outcomes in Non-Small Cell Lung Cancer Patients with Erlotinib as Salvage Treatment

Kim

Lee²,

Sun³

et al. 2010

Oncology

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Purpose: To devise a prognostic model based on clinical parameters for non-small cell lung cancer (NSCLC) patients treated with erlotinib as a salvage therapy. Patients and Methods: Between July 2006 and September 2008, two hundred fifty-seven metastatic/relapsed NSCLC patients who had been treated with erlotinib as a salvage therapy were analyzed retrospectively. Results: For the 257 patients, the median overall survival (OS) and progression-free survival (PFS) with erlotinib treatment were 12.4 and 2.8 months. Multivariate analysis showed that an ECOG performance status of 2 or more, an elevated serum LDH level, and the absence of skin rash were independent adverse prognostic factors for OS and that the presence of intra-abdominal metastasis, 2 or more prior chemotherapy regimens, and the absence of skin rash were prognostic factors for PFS. Patients were categorized into the following 4 prognosis groups on the basis of each adverse prognostic factor: good, intermediate, poor, and very poor prognosis. The median OS times for the good, intermediate, poor, and very poor prognosis groups were 22.0, 9.3, 5.4, and 2.7 months (p < 0.001) and the median PFS times were 6.5, 3.0, 1.2, and 0.9 months (p < 0.001). Conclusion: This prognostic model based on clinical parameters would be useful to identify patients who might be most likely to benefit from erlotinib therapy in clinical practice.

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“…Apart from the EGFR status, other factors have been suggested to be predictive biomarkers of a positive outcome after receiving an EGFR inhibitor, including smoking history, female gender, Japanese ethnicity, adenocarcinoma with bronchoalveolar characteristics and the development of a skin rash (7,8). Both patients described herein were Caucasian.…”

Section: Discussionmentioning

confidence: 94%

Long-term disease stabilization following treatment with erlotinib in heavily pretreated patients with wild-type epidermal growth factor receptor non-small-cell lung carcinoma: Two case reports

Sakellakis

Koutras

Pittaka

et al. 2016

Molecular and Clinical Oncology

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Abstract. Lung adenocarcinomas carrying epidermal growth factor receptor (EGFR) mutations have been identified as a unique group of entities that depend on EGFR for their proliferation and metastasis. The introduction of reversible EGFR tyrosine kinase inhibitors, such as erlotinib, has significantly affected the management of metastatic disease in this subset of patients. Interestingly, although erlotinib is highly effective in patients with EGFR mutations, it may occasionally prove useful, even in the absence of mutations. We herein present the course of two heavily pretreated patients who achieved remarkable disease stabilization over several years, despite harbouring no EGFR mutations. Our cases underscore the fact that further research is required to identify which subset of patients will benefit the most from this treatment, as a substantial minority may present with favourable outcomes.

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Skin rash and bronchoalveolar histology correlates with clinical benefit in patients treated with gefitinib as a therapy for previously treated advanced or metastatic non-small cell lung cancer

Cited by 54 publications

References 41 publications

18F-Fluoro-2-Deoxy-Glucose Uptake Predicts Clinical Outcome in Patients with Gefitinib-Treated Non–Small Cell Lung Cancer

18F-Fluoro-2-Deoxy-Glucose Uptake Predicts Clinical Outcome in Patients with Gefitinib-Treated Non–Small Cell Lung Cancer

Prognostic Model to Predict Outcomes in Non-Small Cell Lung Cancer Patients with Erlotinib as Salvage Treatment

Long-term disease stabilization following treatment with erlotinib in heavily pretreated patients with wild-type epidermal growth factor receptor non-small-cell lung carcinoma: Two case reports

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