Prognostic model to predict outcomes in nonsmall cell lung cancer patients treated with gefitinib as a salvage treatment |
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| Authors: | Min Jae Park MD Jeeyun Lee MD PhD Jung Yong Hong MD Moon Ki Choi MD Joon Ho Yi MD Su Jin Lee MD Suk Joong Oh MD PhD Jin Seok Ahn MD PhD Keunchil Park MD PhD Myung Ju Ahn MD PhD |
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| Institution: | 1. Division of Hematology‐Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea;2. The first 2 authors contributed equally to this work.;3. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University, School of Medicine, Seoul, Korea;4. Fax: (011) 82‐2‐3410‐1754 |
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| Abstract: | BACKGROUND: A prognostic model based on clinical parameters for nonsmall cell lung cancer (NSCLC) patients treated with gefitinib (250 mg/day) as a salvage therapy was devised. METHODS: Clinical data regarding a total of 316 metastatic or recurrent NSCLC patients who were treated with gefitinib were analyzed. RESULTS: Poor prognostic factors for overall survival (OS) by multivariate analysis were an Eastern Cooperative Oncology Group (ECOG) performance status of 2 to 3 (hazards ratio HR] of 2.07; 95% confidence interval CI], 1.57‐2.73 P < .001]), the presence of intra‐abdominal metastasis (HR of 1.76; 95% CI, 1.33‐2.34 P < .001]), elevated serum alkaline phosphatase (HR of 1.50; 95% CI, 1.13‐2.00 P = .005]), time interval from diagnosis to gefitinib therapy of ≤12 months (HR of 1.48; 95% CI, 1.12‐1.95 P = .005]), low serum albumin (HR of 1.45; 95% CI, 1.09‐1.92 P = .009]), progression‐free interval for previous chemotherapy of ≤12 weeks (HR of 1.40; 95% CI, 1.0‐1.84 P = .015]), white blood cell >10,000/μL (HR of 1.38; 95% CI, 1.02‐1.85 P = .032]), and ever‐smoker (HR of 1.33; 95% CI, 1.02‐1.75 P = .033]). Of the 272 patients applicable to this prognostic model, 41 patients (15%) were categorized as a good prognosis group (0‐1 risk factors), 100 patients (37%) as an intermediate prognosis group (2‐3 risk factors), 81 patients (30%) as a poor prognosis group (4‐5 risk factors), and 50 patients (16%) as a very poor prognosis group (≥6 risk factors). The median OS from the time of gefitinib treatment for the good, intermediate, poor, and very poor prognosis groups were 18.0 months, 11.2 months, 4.0 months, and 1.3 months, respectively (P < .001). CONCLUSIONS: This prognostic model based on easily available clinical variables would be useful to identify patients who might derive more benefit from gefitinib treatment and to make decisions in clinical practice. Cancer 2009. © 2009 American Cancer Society. |
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| Keywords: | gefitinib nonsmall cell lung cancer prognostic model outcome |
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