Department of Respiratory Care, College of Medicine, Chang Gung University, Chiayi, Taiwan.
Kaohsiung J Med Sci. 2010 Jan;26(1):1-7. doi: 10.1016/S1607-551X(10)70001-2.
Gefitinib, a selective epidermal growth factor receptor tyrosine kinase inhibitor, is effective in treating patients with non-small cell lung cancer (NSCLC) after unsuccessful chemotherapy. However, survival outcomes and predictors for its effectiveness in chemotherapy-naive NSCLC patients are still not clear. The goal of this study was to investigate the response and survival rates and identify the predictive factors for patients with advanced or metastatic disease receiving gefitinib as first-line therapy. We retrospectively analyzed the response and survival rates of patients with advanced or metastatic NSCLC who had received gefitinib as first-line therapy across six medical institutes in Southern Taiwan between May 2004 and April 2006. The relationship between the response and survival rates to the known predictive factors for gefitinib response and survival was also investigated. A total of 97 patients (65 females and 32 males) were enrolled in this study. Seventy-four patients (76%) had never smoked. Eighty-eight patients (91%) had adenocarcinoma or bronchioloalveolar cell carcinoma. The objective response rate was 56% and the disease control rate (partial response plus stable disease) was 76%. Only poor performance status (Eastern Cooperative Oncology Group score, 3-4) was statistically significantly associated with overall response in this study. The 1-year survival rate was 77%. We suggest that first-line gefitinib monotherapy is promising in some subgroups of Asian patients with NSCLC. Further randomized controlled studies are needed to validate the effectiveness of first-line gefitinib therapy.
吉非替尼是一种选择性表皮生长因子受体酪氨酸激酶抑制剂，对化疗失败的非小细胞肺癌（NSCLC）患者有效。然而，对于化疗初治的 NSCLC 患者，其生存结局和有效性的预测因素仍不清楚。本研究的目的是探讨接受吉非替尼一线治疗的晚期或转移性疾病患者的反应率和生存率，并确定其预测因素。我们回顾性分析了 2004 年 5 月至 2006 年 4 月台湾南部六家医疗机构接受吉非替尼一线治疗的晚期或转移性 NSCLC 患者的反应率和生存率。还研究了已知的吉非替尼反应和生存预测因素与反应率和生存率之间的关系。本研究共纳入 97 例患者（65 例女性和 32 例男性）。74 例患者（76%）从不吸烟。88 例患者（91%）为腺癌或细支气管肺泡细胞癌。客观缓解率为 56%，疾病控制率（部分缓解加稳定疾病）为 76%。仅较差的体能状态（东部肿瘤协作组评分 3-4）与总体反应在本研究中具有统计学显著相关性。1 年生存率为 77%。我们建议，吉非替尼一线单药治疗在某些亚洲 NSCLC 患者亚组中具有前景。需要进一步的随机对照研究来验证一线吉非替尼治疗的有效性。
