Department of Oncology, National Taiwan University Hospital, 7, Chung-Shan S Rd., Taipei 10002, Taiwan.
Eur J Cancer. 2013 Jan;49(1):106-14. doi: 10.1016/j.ejca.2012.07.014. Epub 2012 Aug 14.
The epidermal growth factor receptor inhibitors, gefitinib and erlotinib, are used as standard salvage therapy for advanced non-small-cell lung cancer (NSCLC). The aim of the present study was to compare their efficacies in this population.
The Taiwan Cancer Registry and the National Health Insurance claim databases were searched for newly diagnosed patients with NSCLC from 2004 to 2007 who received gefitinib or erlotinib as third-line therapy. Overall survival (OS) and time to treatment failure (TTF) were determined from registered parameters. Treatment efficacies were compared by the log-rank test in total population and subsets with different clinical characteristics. The Cox's proportion hazard model was used to estimate the adjusted hazard ratios in multivariate analyses.
A total of 984 patients who received gefitinib (67%) or erlotinib (33%) were included. Patients receiving gefitinib or erlotinib had similar OS (median, 10.2 versus 9.9 months, p=0.524) and TTF (median, 5.5 versus 3.4 months, p=0.103). In multivariate analyses, both treatment groups had similar risk of overall mortality (adjusted hazard ratio [HR]=1.04, p=0.629) and treatment failure (adjusted HR=0.94, p=0.417). Comparing the treatments in subgroups based on age, tumour histology and gender also revealed no differences in OS and TTF. For patients who received gefitinib or erlotinib for more than 3 or 6 months, there was no difference in TTF but patients who received erlotinib had longer OS.
Gefitinib and erlotinib had similar efficacies as salvage therapy for advanced NSCLC in Taiwan.
表皮生长因子受体抑制剂吉非替尼和厄洛替尼被用作晚期非小细胞肺癌（NSCLC）的标准挽救疗法。本研究旨在比较这两种药物在该人群中的疗效。
从 2004 年至 2007 年，通过检索台湾癌症登记处和全民健康保险理赔数据库，筛选出接受吉非替尼或厄洛替尼作为三线治疗的新诊断 NSCLC 患者。从注册参数中确定总生存期（OS）和治疗失败时间（TTF）。在总人群和具有不同临床特征的亚组中，通过对数秩检验比较治疗效果。使用 Cox 的比例风险模型在多变量分析中估计调整后的风险比。
共纳入 984 例接受吉非替尼（67%）或厄洛替尼（33%）治疗的患者。接受吉非替尼或厄洛替尼治疗的患者 OS（中位数为 10.2 与 9.9 个月，p=0.524）和 TTF（中位数为 5.5 与 3.4 个月，p=0.103）相似。多变量分析显示，两组患者的总死亡率（调整后的风险比[HR]=1.04，p=0.629）和治疗失败率（调整后的 HR=0.94，p=0.417）相似。根据年龄、肿瘤组织学和性别对治疗组进行亚组比较，OS 和 TTF 也无差异。对于接受吉非替尼或厄洛替尼治疗超过 3 或 6 个月的患者，TTF 无差异，但接受厄洛替尼治疗的患者 OS 更长。
吉非替尼和厄洛替尼作为晚期 NSCLC 的挽救疗法在台湾具有相似的疗效。
