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Gefitinib (G) treatment outcome after progression on erlotinib (E) in patients with advanced non-small cell lung cancer (NSCLC)

2007; Lippincott Williams & Wilkins; Volume: 25; Issue: 18_suppl Linguagem: Inglês

10.1200/jco.2007.25.18_suppl.18138

1527-7755

Francesco Grossi, Annalisa Brianti, Carlotta Defferrari, Maura Loprevite, Gianluca Catania, P. Pronzato,

Lung Cancer Diagnosis and Treatment

18138 Background: Two case reports describe a response to E after failure of G (Garfield DH, J Clin Oncol 2005) or to G after failure of E (Choong NW et al, Nat Clin Pract Oncol 2006) in patients (pts) with advanced NSCLC. Otherwise, a limited experience in 5 pts suggests that E is not effective in pts progressing on G (Viswanathan A et al, Lung Cancer 2005). Aim of this study was the evaluation of response and time to progression (TTP) in advanced NSCLC pts treated with G after failure of E. Methods: Pts received G 250 mg/day after disease progression (PD) with E 150 mg/day. Pts accrual was stopped on August 2006 after the approval of E for use in Italy and the consequent closure of the G compassionate-use program. Results: From May 2005 to August 2006, 15 pts were enrolled. Median age 65 years (50–85); males= 14 pts (93%); never/former smokers= 4/10 pts (26/67%); adenocarcinoma= 10 pts (67%); PS 0/1= 5/10 pts (33/67%); in 2 pts (13%) E was administered as first-line therapy, 8 pts (53%) received 2 prior lines of chemotherapy (CT) and 3 pts (20%) received CT between E and G. One patient (7%) had a partial response (PR) and 5 pts (33%) had disease stabilization (SD) with E; with G no PR and 6 SD (40%) were obtained. Five out of 6 RP/SD pts with E, had SD with G; 8 out of 9 PD pts with E, had PD with G; 1 SD patient with E, progressed with G and 1 vice versa. TTP in RP/SD pts was 7.2 and 3.4 months for E and G respectively; in PD pts TTP was 1.7 and 1.6 for E and G respectively. Conclusions: Our data suggest that there is a benefit with G in pts who had RP/SD with E and that is associated with a good TTP. Conversely G is not recommended in pts that immediately progressed after E. Moreover these results support the rationale of treating PD pts with an EGFR TKI with another one; it may be worthwhile to collect more data on E. No significant financial relationships to disclose.