Gefitinib is more effective in never-smokers with non-small-cell lung cancer: experience among Asian patients

• Published in: British journal of cancer Vol. 93; no. 1; pp. 23 - 28
• Main Authors: Lim, S-T, Wong, E-H, Chuah, K-L, Leong, S-S, Lim, W-T, Tay, M-H, Toh, C-K, Tan, E-H
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 11.07.2005; Nature Publishing Group
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents - therapeutic use; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Carcinoma, Non-Small-Cell Lung - drug therapy; Clinical Study; Cohort Studies; Drug Resistance; Epidemiology; Female; Gefitinib; Humans; Logistic Models; Lung cancer; Lung Neoplasms - drug therapy; Male; Medical sciences; Middle Aged; Molecular Medicine; Oncology; Pneumology; Proportional Hazards Models; Quinazolines - therapeutic use; Retrospective Studies; Smoking; Survival Analysis; Tumors; Tumors of the respiratory system and mediastinum; never-smoker; gefitinib; non-small-cell lung cancer; Antineoplastic agent; Human; Lung disease; Asiatic; Respiratory disease; Enzyme; Transferases; Lung cancer; Enzyme inhibitor; Malignant tumor; non-small cell lung carcinoma; Epidermal growth factor receptor; Non smoker; Cancerology; Efficiency; Smoker; Bronchus disease; Gefitinib; Protein-tyrosine kinase
• DOI: 10.1038/sj.bjc.6602652
• ISSN: 0007-0920

We retrospectively analysed the results of patients with advanced non-small-cell lung cancer treated with gefitinib to derive clinical factors predictive of response and a favourable survival outcome. Patients were treated with gefitinib 250 mg per day and re-evaluated 4–8 weeks later with repeat CT scan and every 8 weeks thereafter to assess response and the duration of response. Pathology review by a histopathologist was conducted, in particular to confirm a recently published result of bronchioloalveolar carcinoma histology or its components as predictive of response to gefitinib. Logistic regression and Cox regression analytical methods were applied to determine factors that could predict for response and improved overall survival. A total of 110 patients were treated. The overall response rate was 32% partial responses (PRs). Only never-smoking status was predictive of response in the logistic regression analysis, adjusted OR=6.1, 95% CI=1.7, 21.5. The presence of a PR and good performance status were predictive of a favourable survival outcome from the Cox regression modelling. Responders had an adjusted HR of 3.0, 95% CI=1.5–5.8 compared to nonresponders, while patients with ECOG status 0–1 had an adjusted HR of 0.42, 95% CI=0.25–0.72, compared with patients with ECOG status 2–4. Bronchioloalveolar carcinoma or its components were distinctly absent on pathology review. In conclusions, Never-smoking status is an important clinical predictor of a favourable response to gefitinib.