Comparison of Gefitinib Versus Chemotherapy in Patients with Non-small Cell Lung Cancer with Exon 19 Deletion

Anticancer Res. 2015 Dec;35(12):6957-61.

Abstract

Background: Second-generation epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) afatinib as first-line treatment has been demonstrated to improve overall survival (OS) in patients with non-small cell lung cancer (NSCLC) harboring an exon 19 deletion (del19) of EGFR compared to platinum-doublet chemotherapy. However, it is unclear whether first-generation EGFR-TKIs improve OS in patients with del19 in the first-line treatment.

Patients and methods: We performed a post-hoc analysis of patients with del19 or L858R mutation of EGFR who received gefitinib in the NEJ002 study, which compared gefitinib to carboplatin-paclitaxel.

Results: A total of 58 patients and 57 patients with del19 EGFR received gefitinib and carboplatin-paclitaxel, respectively. No OS differences were observed between patients receiving gefitinib and carboplatin-paclitaxel irrespective of del19 (29.3 months vs. 29.7 months, p=0.53) or L858R (28.4 months vs. 25.1 months, p=0.45).

Conclusion: In contrast to afatinib, it is suggested that first-line gefitinib does not improve OS in patients with del19 of EGFR compared with platinum-doublet chemotherapy.

Keywords: EGFR mutation; Gefitinib; L858R; exon 19 deletion; non-small cell lung cancer.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carboplatin / administration & dosage
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / genetics
  • ErbB Receptors / genetics*
  • Exons
  • Gefitinib
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Mutation
  • Paclitaxel / administration & dosage
  • Quinazolines / therapeutic use*
  • Retrospective Studies
  • Sequence Deletion

Substances

  • Antineoplastic Agents
  • Quinazolines
  • Carboplatin
  • EGFR protein, human
  • ErbB Receptors
  • Paclitaxel
  • Gefitinib