Second-line treatments after first-line gefitinib therapy in advanced nonsmall cell lung cancer

✍ Scribed by Jenn-Yu Wu; Jin-Yuan Shih; Chih-Hsin Yang; Kuan-Yu Chen; Chao-Chi Ho; Chong-Jen Yu; Pan-Chyr Yang

• Publisher: John Wiley and Sons
• Year: 2010
• Tongue: French
• Weight: 236 KB
• Volume: 126
• Category: Article
• ISSN: 0020-7136
• DOI: 10.1002/ijc.24657

✦ Synopsis

Abstract

Gefitinib is effective as first‐line therapy for advanced nonsmall cell lung cancer (NSCLC). However, after failure of gefitinib, it is unknown whether any second‐line regimens could lead to better outcomes. To study the influence of different second‐line antitumor regimens on the outcomes of patients with NSCLC after failure of first‐line gefitinib, we carried out a retrospective study in a tertiary referral medical center to investigate the prognosis of patients with NSCLC receiving second‐line antitumor treatment after gefitinib therapy. Clinical data and epidermal growth factor receptor (EGFR) mutational status of tumors were collected. A total of 195 patients with Stage IIIb or IV NSCLC receiving first‐line gefitinib and at least 1 subsequent line therapy were identified. A second‐line therapy with a platinum‐based combination or taxane‐containing regimen were associated with a higher therapy response, whereas a platinum‐based combination was linked to better overall survival. Ninety‐five patients had tumors with known EGFR mutation status; 61 had EGFR mutations and 34 had wild‐type EGFR. A second‐line therapy with a gemcitabine/platinum combination regimen resulted in better overall survival than erlotinib in patients with EGFR mutations (p = 0.035) but not in patients with wild‐type EGFR (p = 0.785). The study suggested that, after failure of first‐line gefitinib therapy, second‐line platinum‐based combination regimens were associated with a better overall survival than other regimens, including erlotinib. The survival benefit of platinum‐based combination regimens existed in patients with mutant EGFR but not wild‐type EGFR.