Yang Chih-Hsin, Shih Jin-Yuan, Chen Kun-Chieh, Yu Chong-Jen, Yang Tsung-Ying, Lin Ching-Pei, Su Wen-Pin, Gow Chien-Hung, Hsu Chiun, Chang Gee-Chen, Yang Pan-Chyr
Department of Oncology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China.
Cancer. 2006 Oct 15;107(8):1873-82. doi: 10.1002/cncr.22220.
Chemonaive patients had higher response rates than chemotherapy-treated patients in previous analyses of East Asian patients with advanced nonsmall cell lung cancer. The survival outcome and the predictors for antitumor activity in chemonaive patients who received gefitinib as first-line treatment are unclear.
Clinicopathologic predictive factors, objective tumor responses, and the survival of consecutive patients with advanced, chemonaive nonsmall cell lung cancer who received gefitinib as first-line treatment were collected and analyzed. Multivariate analysis was conducted to determine independent predictive factors for gefitinib antitumor efficacy.
One hundred ninety-six patients (112 males and 84 females) were analyzed. Ninety-six patients (49%) were never smokers. One hundred forty-four patients (73%) had adenocarcinoma or bronchioloalveolar carcinoma histology. One hundred twenty patients had an Eastern Cooperative Oncology Group performance status 0 to 2. Eighty-three patients (42%; 95% confidence interval, 36-49%) had an objective tumor response. An additional 35 patients had stable disease (disease control rate, 61%). The tumor response rate was 52% in patients who had a good performance status. Female gender, nonsmoking status, and adenocarcinoma histology all were independent predictors of response or disease control in multivariate analysis. The median survival was 11.1 months, and the 1-year survival rate of patients who had a good performance status was 47.5%.
The response rate to gefitinib was high in East Asian chemonaive patients with advanced nonsmall cell lung cancer. Female gender, adenocarcinoma histology, and nonsmoking status all were independent predictors of gefitinib response. The survival outcome of these patients was similar to that of patients who initially received chemotherapy.
在既往对东亚晚期非小细胞肺癌患者的分析中，初治患者的缓解率高于接受过化疗的患者。接受吉非替尼一线治疗的初治患者的生存结局及抗肿瘤活性的预测因素尚不清楚。
收集并分析连续接受吉非替尼一线治疗的晚期初治非小细胞肺癌患者的临床病理预测因素、客观肿瘤缓解情况及生存情况。进行多因素分析以确定吉非替尼抗肿瘤疗效的独立预测因素。
共分析了196例患者（男112例，女84例）。96例患者（49%）从不吸烟。144例患者（73%）组织学类型为腺癌或细支气管肺泡癌。120例患者东部肿瘤协作组体能状态为0至2。83例患者（42%；95%置信区间，36 - 49%）有客观肿瘤缓解。另外35例患者疾病稳定（疾病控制率为61%）。体能状态良好的患者肿瘤缓解率为52%。在多因素分析中，女性、不吸烟状态及腺癌组织学类型均为缓解或疾病控制的独立预测因素。中位生存期为11.1个月，体能状态良好的患者1年生存率为47.5%。
东亚晚期初治非小细胞肺癌患者对吉非替尼的缓解率较高。女性、腺癌组织学类型及不吸烟状态均为吉非替尼缓解的独立预测因素。这些患者的生存结局与初始接受化疗的患者相似。
