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Gefitinib with or without Transarterial Infusion Chemotherapy (Cisplatin) for Large Nonsmall Cell Lung Cancer with Epidermal Growth Factor Receptor Mutations
Authors:Ying-Qiang Zhang  Li-Juan Jiang  Su-Xiang Jiang  Yin-Feng Xu  Bei-Bei Zhou  Gui-Hua Huang  Di-Min Liu  Yu Wang  Wen-Zhe Fan  Jia-Ping Li  Bo Wang
Affiliation:1. Department of Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China;2. Department of Oncology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China;3. Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, Shenzhen, China;4. Department of Hand Surgery & Microsurgery, The First Affiliated Hospital, Sun Yat-sen University, Shenzhen, China;5. Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Shenzhen, China;6. State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China;7. Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China
Abstract:
PurposeTo retrospectively investigate the safety and benefit of gefitinib plus transarterial infusion (TAI) therapy as a first-line treatment compared to gefitinib alone for patients with large (>7 cm) nonsmall cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations.Materials and MethodsBetween January 2010 and December 2013, 92 consecutive treatment-naïve patients with large NSCLC with EGFR mutations, who were treated using gefitinib plus TAI (G+T, n = 42) or gefitinib alone (G, n = 50) were reviewed. The primary endpoints were the objective response rate (ORR) and tumor reduction rate. The secondary endpoints were progression-free survival (PFS) and overall survival (OS), and safety was also assessed.ResultsThe baseline characteristics of the 2 groups were balanced, and no patients experienced treatment-related death. Toxicity outcomes did not differ between the G+T and G groups. The tumor reduction rate in the G+T group was significantly higher than that in the G group (42.9 vs 31.9%, P = .028). The ORR was 83% in the G+T group and 72% in the G group (P = .197). The median PFS was significantly longer in the G+T group than in the G group (14.0 vs 10.0 months, P = .023). The median OS was 30.0 months in the G+T group and 27.0 months in the G group (P = .235).ConclusionsThis study suggests that compared with gefitinib alone, combination therapy with gefitinib plus TAI was well tolerated and potentially improved the tumor reduction rate and PFS in patients with large NSCLC with EGFR mutations.
Keywords:BAI  transbronchial arterial infusion  CR  complete response  CTCAE  Common Terminology Criteria for Adverse Events  DCR  disease control rate  ECOG  Eastern Cooperative Oncology Group  EGFR  epidermal growth factor receptor  G+T  gefitinib plus transarterial infusion therapy  NSCLC  nonsmall cell lung cancer  ORR  objective response rate  OS  overall survival  PFS  progression-free survival  PR  partial response  RECIST  Response Evaluation Criteria in Solid Tumors  SD  stable disease  TAI  transarterial infusion therapy  TKI  tyrosine kinase inhibitor
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