Efficacy and safety of rechallenge treatment with gefitinib in patients with advanced non-small cell lung cancer

Federico Cappuzzo, Alessandro Morabito, Nicola Normanno, P. Bidoli, Alessandro Del Conte, L. Giannetta, Agnese Montanino, F. Mazzoni, Roberta Buosi, Marco Angelo Burgio, Giulio Cerea, Rita Chiari, D. L. Cortinovis, Giovanna Finocchiaro, Luisa Foltran, M. R. Migliorino, Marcello Tiseo, Silvia Ferrari, Filippo De Marinis

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Abstract

Objectives Although patients with advanced non-small cell lung cancer (NSCLC) and an activating epidermal growth factor receptor (EGFR) mutation benefit from the use of EGFR-tyrosine kinase inhibitors (TKI), most of them progress within 12 months from treatment start due to acquired resistance. In clinical practice, many physicians frequently offer these patients retreatment with EGFR-TKIs after a chemotherapy break, based on small or retrospective studies. Materials and methods A phase II trial was conducted in patients with stage III/IV NSCLC, to assess the efficacy, safety and impact on quality of life (QoL) and disease-related symptoms of gefitinib rechallenge. Eligible patients had initially responded to first-line gefitinib and progressed after second-line chemotherapy. Results Of 61 enrolled patients, 73.8% were female, 100% had EGFR-mutated adenocarcinoma and 67.2% were never-smokers. Thirty-two (52.5%) patients obtained a clinical benefit, with 3 (4.9%) achieving a partial response and 29 (47.5%) having stable disease. Median progression-free survival was 2.8 months, overall survival 10.2 months and duration of gefitinib treatment 3.6 months. The most common all grade-adverse events were diarrhea (27.6%), nausea and/or vomiting (20.3%), rash (14.7%) and dyspnea (10.3%); no new toxicities were apparent. Conclusion Findings from this study indicate that gefitinib rechallenge offers modest benefit and may be taken into consideration only for patients for whom no other treatment option exists.

Original languageEnglish
Pages (from-to)31-37
Number of pages7
JournalLung Cancer
Volume99
DOIs
Publication statusPublished - Sep 1 2016

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Keywords

  • Advanced stage NSCLC
  • EGFR mutation
  • Gefitinib
  • Rechallenge

ASJC Scopus subject areas

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

Cappuzzo, F., Morabito, A., Normanno, N., Bidoli, P., Del Conte, A., Giannetta, L., Montanino, A., Mazzoni, F., Buosi, R., Burgio, M. A., Cerea, G., Chiari, R., Cortinovis, D. L., Finocchiaro, G., Foltran, L., Migliorino, M. R., Tiseo, M., Ferrari, S., & De Marinis, F. (2016). Efficacy and safety of rechallenge treatment with gefitinib in patients with advanced non-small cell lung cancer. Lung Cancer, 99, 31-37. https://doi.org/10.1016/j.lungcan.2016.06.008