The EGFR mutation and its correlation with response of gefitinib in previously treated Chinese patients with advanced non-small-cell lung cancer

• Published in: Annals of oncology Vol. 16; no. 8; pp. 1334 - 1342
• Main Authors: Zhang, X.-T., Li, L.-Y., Mu, X.-L., Cui, Q.-C., Chang, X.-Y., Song, W., Wang, S.-L., Wang, M.-Z., Zhong, W., Zhang, L.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.08.2005; Oxford University Press
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - genetics; Adenocarcinoma - pathology; Adult; Aged; Aged, 80 and over; Antineoplastic agents; Antineoplastic Agents - therapeutic use; Base Sequence; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - drug therapy; Carcinoma, Non-Small-Cell Lung - genetics; Carcinoma, Non-Small-Cell Lung - pathology; China - epidemiology; DNA Mutational Analysis; DNA, Neoplasm - genetics; EGFR mutation; ErbB Receptors - antagonists & inhibitors; ErbB Receptors - genetics; Female; Gefitinib; Humans; Lung Neoplasms - drug therapy; Lung Neoplasms - genetics; Lung Neoplasms - pathology; Male; Medical sciences; Middle Aged; Molecular Sequence Data; Mutation - genetics; non-small-cell lung cancer; p-EGFR; Pharmacology. Drug treatments; Phosphorylation; Pneumology; predictive marker; Prognosis; Quinazolines - therapeutic use; Survival Rate; targeted therapy; Treatment Outcome; Tumors of the respiratory system and mediastinum; Asia; China; EGFR mutation; targeted therapy; p-EGFR; gefitinib; predictive marker; non-small-cell lung cancer; Antineoplastic agent; Correlation; Targeting; Lung cancer; Biological marker; non-small cell lung carcinoma; Epidermal growth factor receptor; Target; Bronchus disease; Genetics; Advanced stage; Gefitinib; Protein-tyrosine kinase; Human; Lung disease; Respiratory disease; Enzyme; Transferases; Enzyme inhibitor; Malignant tumor; Treatment; Chinese; Mutation
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mdi340

Background: The aim of the study was to evaluate the efficacy of gefitinib and the epidermal growth factor receptor (EGFR) mutation to gefitinib response in a series of Chinese patients with pretreated advanced non-small-cell lung cancer (NSCLC). Methods: A total of 98 patients who had failed at least one platinum-based regimen received gefitinib 250mg once daily. The mutation analysis of the EGFR kinase domain was performed for 30 patients using paraffin-embedded tumor tissue. Results: The response rate was 31.6% and the disease control rate was 67.3%. Objective response was correlated with adenocarcinoma, female gender and non-smokers. Median progress free survival (PFS) was 7.0 months, median overall survival (OS) was 12.0 months and 1-year survival was 53.1%. The median PFS and OS were improved among patients with adenocarcinoma, gefitinib responders and non-smokers. Active gene mutation was detected in 12 patients. Mutation rates were higher among gefitinib responders, non-smokers, patients with adenocarcinoma and female patients. OS was longer for patients with gene mutation than for patients without mutation. Conclusion: Gefitinib demonstrated significant antitumor activity with a favorable toxicity profile for pretreated Chinese patients with advanced NSCLC. The active mutation of the EGFR kinase domain was strongly associated with response to gefitinib and prolonged overall survival.