Source: Annual Congress 2009 - Treatment of lung cancer
Disease area: Thoracic oncology

Abstract

Background: Chemotherapy is the mainstay treatment for advanced stage Non-small cell lung cancer (NSCLC). Gefitinib, an epidermal growth factor receptor - tyrosine kinase inhibitor (EGFR-TKI) has been shown to be effective treatment in patients of advanced stage NSCLC, especially for those with favourable clinical features such as female, non-smoker and adenocarcinoma. However, resistant to gefitinib ensues invariably and there is little evidence as for the effectiveness of the subsequent salvage treatment.
Aim: To evaluate the efficacy of erlotinib, another EGFR-TKI, when there is disease progression after gefitinib.
Method: We retrospectively evaluated the NSCLC patients with favourable clinical features who received gefitinib as first EGFR-TKI treatment and subsequent erlotinib during the course of their treatment. Disease response is classified as partial response (PR), stable disease (SD) and progressive disease according to RECIST criteria. Disease control is defined as radiological findings (PR+SD) with clinical improvement or stability for at least 4 weeks.
Results: A total of 21 patients with NSCLC were included in the study. Among them, 18 (85.7%) patients had disease control with gefitinib and 11 (52.4%) patients with erlotinib. There is an association between the disease control rate with gefitinib and erlotinib (p=0.016). The disease control rate of erlotinib was independent of the chemotherapy use between the two EGFR-TKIs. No serious side effect was reported in this group of patients.
Conclusion: For NSCLC patients with favourable clinical features, erlotinib might be considered as effective treatment in patients who had disease control with gefitinib.

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Citations should be made in the following way:
M. Wong, A. Lo, J. Lam, B. Lam, J. Wang, D. Lam, M. Ip, J. Ho (Hong Kong, Hong Kong; Macao, Macao). Erlotinib as salvage treatment after failure to gefitinib in non-small cell lung cancer. Eur Respir J 2009; 34: Suppl. 53, 2649

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