A comparison of gefitinib for advanced non-small cell lung cancer patients with different EGFR mutation types.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20544-e20544
Author(s):  
Haijun Zhang ◽  
Nishant Patel ◽  
Pingping Wu
Keyword(s):  
Egfr Mutation ◽  
Haematological Toxicity ◽  
Small Cell ◽  
Second Line ◽  
Small Cell Lung ◽  
First Line ◽  
Second Line Therapy ◽  
First Line Therapy ◽  
Line Therapy ◽  
Exon 19 Deletion

e20544 Background: The aim of this study was to compare the efficacy and toxicity of gefitinib as first or second line therapy for advanced non-small cell lung cancer (NSCLC) patients with positive exon 21 (L858R) or exon 19 deletion mutation. Methods: We retrospectively analyzed the clinical data of 60 endothelial growth factor receptor ( EGFR) mutated advanced lung adenocarcinoma patients from July 2011 to November 2015, who have received oral gefitinib 250 mg once daily. Gefitinib was taken until disease progression, intolerable toxicity or death. Results: At the time of last follow-up visit, 1 death had occurred. Among the 59 patients who remained survival, 17 patients progressed. Overall, the median progression-free survival (mPFS) was 10 months (95% confidence interval (CI): 7.53–12.46 months, p < 0.05). The response rate (RR) and disease control rate (DCR) were 33.33% and 71.66%, respectively. However, there was longer mPFS in first line therapy than that in second line therapy: in first-line gefitinib therapy, mPFS was 12 months among 41 patients (95% CI: 9.58–14.41 months, p < 0.05); in the second line therapy, mPFS was 7 months among 19 patients (95% CI: 1.31–12.68 months, p < 0.05). Furthermore, in subgroup analyses examining different EGFR mutation types, we noted mPFS was significantly longer for patient with exon 19 deletion than that with positive exon 21in both first line therapy and second line therapy. The most common Grade 1 or 2 adverse events included rash (76.6%), abnormal liver function (60%), dry skin (48.3%), diarrhoea (46.6%), fatigue (40%) and paronychia (33.3%) etcetera in non-haematological toxicity, whereas anemia(33.3%), leukocytopenia (20%) etcetera were included in haematological toxicity. Conclusions: Patients with NSCLC who were selected by positive exon 21 or 19 deletion mutations had significantly longer mPFS in first line therapy than that in second line therapy when treated with gefitinib. And EGFR mutation types may influence the response to gefitinib therapy.

Phase II Study of Amrubicin As Second-Line Therapy in Patients With Platinum-Refractory Small-Cell Lung Cancer

2010 ◽  
Vol 28 (15) ◽  
pp. 2598-2603 ◽  
Author(s):  
David S. Ettinger ◽  
Robert Jotte ◽  
Paul Lorigan ◽  
Vicram Gupta ◽  
Lawrence Garbo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Phase Ii Study ◽  
Small Cell ◽  
Second Line ◽  
Small Cell Lung ◽  
First Line ◽  
Second Line Therapy ◽  
First Line Therapy ◽  
Line Therapy ◽  
Platinum Refractory

Purpose Amrubicin is a synthetic anthracycline with potent topoisomerase II inhibition. This phase II study was conducted to confirm safety and activity of amrubicin in the treatment of refractory small-cell lung cancer (SCLC). Patients and Methods Patients with refractory SCLC (either with progressive disease as best response or progression within 90 days of first-line therapy) received amrubicin (40 mg/m2/d for 3 every 21 days). The primary end point was overall response rate (ORR); secondary end points included progression-free survival (PFS), overall survival (OS), and change in left ventricular ejection fraction (LVEF). Results Seventy-five patients with a median progression-free interval after first-line therapy of 38 days were enrolled; 69 patients received a median of four amrubicin cycles (range, one to 12 cycles). The ORR was 21.3% (95% CI, 12.7% to 32.3%), with one complete response (1.3%) and 15 partial responses (20%). Median PFS and OS were 3.2 months (95% CI, 2.4 to 4.0 months) and 6.0 months (95% CI, 4.8 to 7.1 months), respectively. The ORR in 43 patients who never responded to first-line therapy was 16.3% (95% CI, 6.8% to 30.7%). Most commonly reported grade 3 or 4 adverse events included neutropenia (67%), thrombocytopenia (41%), and anemia (30%), with febrile neutropenia in 12%. There was no decrease in mean LVEF with cumulative amrubicin doses exceeding 750 mg/m2. Conclusion Single-agent amrubicin showed promising activity with a 21.3% ORR and an acceptable safety profile when used as second-line therapy patients with platinum-refractory SCLC. Amrubicin did not induce early cardiotoxicity, but its long-term effects are unknown.

scholarly journals Duration of treatment among patients prescribed afatinib or erlotinib as first-line therapy for EGFR mutation-positive non-small-cell lung cancer in the USA

2019 ◽  
Vol 15 (13) ◽  
pp. 1493-1504 ◽  
Author(s):  
Jonathan Lim ◽  
Carl Samuelsen ◽  
Amanda Golembesky ◽  
Sulena Shrestha ◽  
Li Wang ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Egfr Mutation ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Duration Of Treatment ◽  
First Line Therapy ◽  
Line Therapy ◽  
The Usa

Comparison of clinical outcome between gefitinib and erlotinib treatment in patients with non-small cell lung cancer harboring an epidermal growth factor receptor exon 19 or exon 21 mutations.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19051-e19051
Author(s):  
Sung Hee Lim ◽  
Ji Yoon Lee ◽  
Jong-Mu Sun ◽  
Jin Seok Ahn ◽  
Keunchil Park ◽  
...  
Keyword(s):  
Egfr Mutation ◽  
Performance Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
First Line ◽  
Ecog Performance Status ◽  
First Line Therapy ◽  
Line Therapy ◽  
Significant Difference ◽  
Egfr Tki

e19051 Background: Gefitinib and erlotinib are small-molecule kinase inhibitors that inhibit signaling via EGFR and both agents showed dramatic response rate and prolonged PFS in patients harboring activating EGFR mutation. We investigated the clinical outcomes between gefitinib- and erlotinib-treated patients with recurrent or metastatic non-small cell lung cancer (NSCLC) harboring EGFR mutations. Methods: A total 375 patients with recurrent or metastatic NSCLC who had either an exon 19 deletion or L858R mutation on exon 21 and received gefitinib (n=228) or erlotinib (n=147) therapy between August 2007 and December 2011 were retrospectively reviewed. By using a matched-pair case-control study design, 121 pairs of gefitinib-treated and erlotinib-treated patients were matched according to sex, smoking history, ECOG performance status, and types of EGFR mutation. Results: The median age of all patients was 58 years (range, 30-84) and more than half of patients were never smokers (63.6%). Most patients had adenocarcinoma (98.3%) and good ECOG performance status (0, 1) (90.9%). Of 242 patients, 64 (26.4%) received an EGFR TKI as first line therapy. The overall response rates and disease control rates in the gefitinib-treated and erlotinib-treated groups were 85.5% versus 79.8 % (p=.375) and 94.0% versus 89.1%, respectively (p=.242). There was no statistically significant difference noted with regard to OS (median, 38.9 vs 37.5; p=.642) and PFS (median, 12.9 vs 10.1; p=.135) between the gefitinib-treated and erlotinib-treated groups. For a subgroup which patients were treated with TKI as first line therapy, the overall response rates were higher than those of patients who had progressed on prior chemotherapy (90.3% vs 79.9%; p=.063). However, there was no significant difference in PFS (median, 13.3 vs 10.3; p=.134) between subjects with first line TKI therapy and more than second line treatment. Conclusions: Both gefitinib and erlotinib showed similar effective activity in selected population of NSCLC that harbored an EGFR mutation and further studies are needed to evaluate the efficacy of EGFR TKI as first line treatment.

scholarly journals Patients with non-small-cell lung cancer harbouring a BRAF mutation: a multicentre study exploring clinical characteristics, management, and outcomes in a real-life setting: EXPLORE GFPC 02-14

2018 ◽  
Vol 25 (5) ◽  
Author(s):  
J. B. Auliac ◽  
S. Bayle ◽  
A. Vergnenegre ◽  
H. Le Caer ◽  
L. Falchero ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Real Life ◽  
Stage Iv ◽  
Small Cell ◽  
Second Line ◽  
Small Cell Lung ◽  
First Line ◽  
First Line Therapy ◽  
Line Therapy ◽  
Nsclc Patients

Background Mutations in BRAF are rare oncogene mutations, found in 2% of non-small-cell lung cancers (nsclcs). Little information is available about the management of patients with BRAF-mutated nsclc, except for those included in clinical trials. We undertook the present study to assess the clinical characteristics, management, and outcomes of those patients in a real-life setting.MethodsThis retrospective multicentre observational study included all patients with BRAF-mutated nsclc diagnosed between January 2012 and December 2014.ResultsPatients (n = 59) from 24 centres were included: 57.6% men; mean age: 64.5 ± 14.5 years; 82% with a performance status of 0–1 at diagnosis; smoking status: 40.3% current, 32.6% former; 93% with adenocarcinoma histology; 75% stage iv; 78% with V600E mutations; 2 with EGFR and 2 with ALK co-mutations. Of the stage iv patients, 79% received first-line therapy (14.2% anti-BRAF), and 48% received second-line treatment (23.8% anti-BRAF). Response rate and progression-free survival were, respectively, 51.7% and 8.7 months [95% confidence interval (ci): 6.4 months to 15.2 months] for first-line therapy and 35.3% and 4.1 months (95% ci: 2 months to 10.9 months) for second-line treatments. The 2-year overall survival was 58.5% (95% ci: 45.8% to 74.8%). Outcomes in patients with stage iv nsclc harbouring BRAF V600E mutations (n = 32) did not differ significantly from those of patients with other BRAF mutations.ConclusionsIn this real-world analysis, most nsclc patients with a BRAF mutation were men and current or former smokers. Survival appears to be better in these BRAF-mutated patients than in nsclc patients without an oncogenic driver.

Randomized Multicenter Phase II Study of Gemcitabine Versus Docetaxel as First-Line Therapy with Second-Line Crossover in Advanced-Stage Non–Small-Cell Lung Cancer

2005 ◽  
Vol 7 (3) ◽  
pp. 208-214 ◽  
Author(s):  
Christian Manegold ◽  
Lothar Richard Pilz ◽  
Gabriele Koschel ◽  
Katrin Schott-von Römer ◽  
Jörg Mezger ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Phase Ii Study ◽  
Small Cell ◽  
Advanced Stage ◽  
Second Line ◽  
Small Cell Lung ◽  
First Line ◽  
First Line Therapy ◽  
Multicenter Phase ◽  
Line Therapy
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