ISSN: 1859 - 2872
The results of gefitinib as a first-line therapy in elderly patients with advanced non-small cell lung cancer with EGFR mutations
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Abstract
Objective: To evaluate the results of gefitinib as a first-line therapy in elderly patients with advanced NSCLC who were positive for epidermal growth factor receptor (EGFR) mutations. Subject and method: This prospective analysis included 72 patients 65 years old or over with advanced NSCLC with EGFR mutations who were administered gefitinib as the first-line therapy. Patient follow-up and evaluation were performed every three months or when there were symptoms of progressive disease. The main criteria for the analysis of response were progression-free survival (PFS) and overall response rate (ORR). The secondary criteria were overall survival (OS) and disease control rate (DCR) and toxicity. Additionally, the relationship of PFS and OS with sex, smoking history, locations of EGFR mutation and performance status (PS) were analyzed. Result: The median of follow-up time was 20.5 months. ORR and DCR were 70.8% and 91.7%, respectively. The median PFS was 14.5 months, and the median OS was 25 months. In patients with 75 years old or over, the median OS was 21 months. The longer OS was statistically significant in the patients had a good PS (29 months versus 15 months, p=0.047). The OS rate at 1, 2, 3, 4 and 5 years were 87.5%, 43.1%, 15.3%, 5.6% and 2.8%, respectively. Adverse events occurred in 62.5% patients, most of them were grade 1 and 2 events. One patients discontinuous gefitinib due to increasing of live enzyme grade 3. Conclusion: This study suggests the effectiveness and the safety of gefitinib as a first-line treatment option in elderly patients with advanced NSCLC and positive EGFR mutations. In particular, it provides the benefit of overall survival for patients with a good PS.
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References
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