Influence of first-line chemotherapy and EGFR mutations on second-line gefitinib in advanced non-small cell lung cancer.

PURPOSE

Gefitinib is a valid second-line therapy for previously treated non-small cell lung cancer (NSCLC) patients. The influences of various chemotherapy regimens and EGFR mutations on effectiveness of second-line gefitinib are not clear, and laboratory studies revealed that previous chemotherapy changed the effectiveness of treatment with gefitinib. In order to clarify the factors changing the effectiveness of second-line gefitinib, we performed a retrospective analysis of the prognosis of NSCLC patients who received gefitinib after first-line chemotherapy.

DESIGN

We analyzed the clinical data and mutational studies of NSCLC patients with EGFR mutations from the National Taiwan University Hospital.

RESULTS

One hundred and two previously treated patients received second-line gefitinib for stage IIIB or IV NSCLC. Fifty of all the 102 patients were sequenced for EGFR status. Twenty-eight had EGFR mutation and 22 had wild type EGFR. The response rate and progression-free survival of second-line gefitinib was not changed by different previous chemotherapy regimens. The potent factor with regards to the effectiveness of second-line gefitinib was EGFR mutation which led to a better response rate and longer progression-free survival of gefitinib than wild type EGFR.

CONCLUSIONS

Gefitinib is effective as a second-line therapy for previously treated NSCLC patients. The effectiveness was influenced by EGFR status rather than previous chemotherapy regimens.