The administration of gefitinib in patients with advanced non-small-cell lung cancer after the failure of erlotinib

Francesco Grossi, Erika Rijavec, Maria Giovanna Dal Bello, Carlotta Defferrari, Annalisa Brianti, Giulia Barletta, Carlo Genova, Carmelina Murolo, Maurizio Cosso, Gabriella Fontanini, Laura Boldrini, Mauro Truini, Paolo Pronzato

Research output: Contribution to journalArticle

Abstract

Purpose: Recent studies have demonstrated that erlotinib therapy may be considered an option for patients with advanced non-small-cell lung cancer who experienced disease progression after treatment with gefitinib, particularly in patients in whom the disease had been stabilized for a long time prior to gefitinib therapy. The aim of this study was to evaluate the disease control rate and toxicity of gefitinib in patients whose disease progressed after erlotinib therapy. Methods: From May 2005 to August 2006, 15 patients received a 250 mg/day dosage of gefitinib after having disease progression while taking erlotinib at a dose of 150 mg/day. Results: Among patients who received erlotinib, 1 (7%) achieved a partial response (PR), and 5 (33%) achieved stable disease (SD). Among patients who received gefitinib, none achieved a PR, and 6 achieved SD (40%). Five out of 6 patients who achieved PR/SD with erlotinib also achieved SD with gefitinib; 8 out of 9 patients who achieved a progressive disease (PD) with erlotinib also achieved a PD with gefitinib. The median time to progression (TTP) and overall survival (OS) were 2.3 and 3.5 months, respectively. The TTP and OS in SD patients were 3.7 and 7.4 months, respectively. The most common toxicities of gefitinib were dry skin (grade 1-2) in 27% of patients and acneiform rashes and rashes/desquamation in 20% of patients. Diarrhea (grade 1-2) occurred in 7% of patients. Conclusions: Our data suggest that patients who achieved PR/SD with erlotinib also benefit from taking gefitinib. Conversely, gefitinib is not recommended in patients whose disease progressed after taking erlotinib.

Original languageEnglish
Pages (from-to)1407-1412
Number of pages6
JournalCancer Chemotherapy and Pharmacology
Volume69
Issue number6
DOIs
Publication statusPublished - Jun 2012

Keywords

  • EGFR mutation
  • EGFR-TKI toxicity
  • Erlotinib
  • Gefitinib
  • K-ras mutation
  • Non-small-cell lung cancer

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pharmacology
  • Pharmacology (medical)
  • Toxicology

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