1343 - Multicenter survey for management beyond progression disease with gefitinib in non-small cell lung cancer

Date 28 September 2012
Event ESMO Congress 2012
Session Publication Only
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
Presenter Toshiyuki Sawa
Authors T. Sawa1, Y. Futamura1, J. Shindoh2, Y. Ohno3, S. Shigeki Satoh4, O. Osamu Taguchi5, M. Morise6, Y. Hasegawa7
  • 1Cancer Center, Gifu Municipal Hospital, 500-8513 - Gifu/JP
  • 2Respiratory Medicine, Ogaki Municipal Hospital, Ogaki/JP
  • 3Respiratory Medicine, Gifu University, 5011194 - Gifu/JP
  • 4Medical Oncology, Nagoya City University, 4678602 - Nagoya/JP
  • 5Respiratory Medicine, Mie University, 5148507 - Tsu/JP
  • 6Respiratory Medicine, Nagoya University, 466-8550 - Nagoya/JP
  • 7Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya/JP

Abstract

Purpose

Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) is effective in patients with activating EGFR mutations, and median time to progression in such patients is generally up to 12 months. Usually, treatment with EGFR-TKI is terminated when disease progression ( PD) is confirmed, while acute exacerbation after the withdrawal of EGFR-TKI has been reported. To investigate current clinical management beyond PD with gefitinib, multicenter survey was conducted in Japan.

Objective

All patients with EGFR mutation-positive non-small cell lung lancer confirmed PD in the treatment of gefitinib in 2010, were included in this survey to evaluate patients characteristics, progression free survival and overall survival with gefitinib, selection of regimen beyond PD, and response rate.

Result

From the six participating institute, 64 cases (median age 69 years old, exon19 in 37 cases, exon18 in 25 cases, another type in 4 cases respectively) had been enrolled. Gefitinib has been used as first line in 35 cases, as second line in 25 cases, as 3rd line or more in 6 cases. Progression free survival was 13 months, and overall survival was 33 months. In PFS and OS, there is no difference between first line and second line use with gefitinib. Response rate shows good efficacy in patients with good performance status. Beyond PD, gefitinib administration was continued in 9 cases (including additional combined therapy in 4 cases), and erlotinib was switched in 15 cases while platinum doublet in 2 cases, another monotherapy in 19 cases respectively. Response rate was shown 22.2% in gefitinib, 26.7% in erlotinib even beyond PD.

Conclusion

In the patients with active EGFR mutation, it is confirmed that antitumor effectiveness is recognized in patients who continues to be treated under EGFR-TKI after progression of gefitinib.

Disclosure

All authors have declared no conflicts of interest.