Gefitinib as first-line treatment in elderly epidermal growth factor receptor-mutated patients with advanced lung adenocarcinoma: results of a Nagano Lung Cancer Research Group study |
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| Authors: | Asami Kazuhiro Koizumi Tomonobu Hirai Kazuya Ameshima Shingo Tsukadaira Akihiro Morozumi Nobutoshi Morikawa Akio Atagi Shinji Kawahara Masaaki |
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| Institution: | 1Department of Internal Medicine, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai, Japan;2Comprehensive Cancer Center, Shinshu University Hospital, Matsumoto, Japan;3Department of Pulmonary Diseases, Nagano Municipal Hospital, Nagano, Japan;4Department of Respiratory Medicine, Fukui University School of Medicine, Fukui, Japan;5Department of Pulmonary Diseases, Iida Municipal Hospital, Iida, Japan;6Department of Pulmonary Diseases, Saku Central Hospital, Saku, Japan;7Department of Respiratory Surgery, Showa Inan Hospital, Komagane, Japan;8Department of Internal Medicine, Federation of National Public Service Personnel Mutual Aid Associations, Otemae Hospital, Osaka, Japan |
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| Abstract: | IntroductionFeasibility of gefitinib therapy in elderly patients with non–small-cell lung cancer is uncertain. This phase II study aimed to investigate the efficacy and usefulness of gefitinib therapy as a first-line treatment for elderly patients who have advanced lung adenocarcinoma with epidermal growth factor receptor (EGFR) mutations.Patients and MethodsWe enrolled chemotherapy-naïve advanced lung adenocarcinoma patients aged 75 years or older. Patients were administered gefitinib (250 mg) once daily until progression or unacceptable toxicity. The primary endpoint was response rate (RR), and secondary endpoints were disease control rate (DCR; defined as complete response CR] plus partial response PR] plus stable disease SD]), progression-free survival (PFS), overall survival (OS), and toxicity profile.ResultsBetween April 2008 and November 2009, 17 lung adenocarcinoma patients were enrolled. Overall RR was 59% (95% confidence interval CI]: 33% to 81%), with 2 patients achieving CR and 8 PR. SD was noted in 5 patients, and DCR was 88% (95% CI: 62% to 98%). Median PFS was 12.9 months (95% CI: 2.2 to 23.6 months), and median OS had not yet been reached. Major grade 3 toxicities were skin rash (12%) and increased levels of aspartate aminotransferase or alanine aminotransferase (18%).ConclusionFirst-line treatment with gefitinib was effective and well-tolerated in elderly patients with EGFR mutations. |
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| Keywords: | EGFR mutation Elderly patients First-line treatment Gefitinib Lung adenocarcinoma |
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