Article (Scientific journals)
Gefitinib monotherapy in advanced nonsmall cell lung cancer: a large Western community implementation study
van Puijenbroek, R.; Bosquee, Léon; Meert, A. P. et al.
2007In European Respiratory Journal, 29 (1), p. 128-33
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Keywords :
Community implementation study; epidermal growth factor; expanded access; gefitinib; nonsmall cell lung cancer; treatment outcome
Abstract :
[en] Epidermal growth factor receptor tyrosine kinase inhibitors represent a new treatment option for patients with advanced nonsmall cell lung cancer (NSCLC). This retrospective study examined to what extent previous clinical trial experience matches largescale Western community implementation of this treatment. In the Belgian expanded access programme, the data from 513 patients with advanced or metastatic NSCLC, not suitable for further chemotherapy and receiving oral gefitinib 250 mg?day-1 until disease progression, death or unacceptable toxicity, were analysed. The median (range) duration of gefitinib treatment was 2.3 months (0.0–32.7). Its use was predominantly in second- or third-line treatment. The overall response and disease control rates were 8.9 and 41.2%, respectively. In univariate analysis, response was more common in females and never-smokers. In multivariate analysis, female sex was the only significant predictive factor (odds ratio (OR) (95% confidence interval (CI)) 0.329 (0.129–0.839)). Symptom improvement was reported in 108 patients of whom 32 (29.6%) had an objective response, 66 (61.1%) experienced disease stabilisation and 10 (9.3%) progressed. Gefitinib was well tolerated; only 7.8% of the patients reported grade 3 or 4 toxicity. The overall median survival was 4.7 months, with a 1-yr survival rate of 21%. Survival was strongly influenced by a better performance status (PS) (good PS: hazard ratio (HR) (95%CI) 0.110 (0.077–0.157)) and adenocarcinoma with bronchioloalveolar carcinoma features histology (HR (95%CI) 0.483 (0.279–0.834)). In conclusion, the activity of gefitinib was confirmed in the present large Western community implementation study. Response, present in a small subgroup, led to a rewarding survival and could be predicted by sex only. Baseline performance status and adenocarcinoma with bronchioloalveolar carcinoma features histology were significant factors for survival.
Disciplines :
Hematology
Cardiovascular & respiratory systems
Oncology
Author, co-author :
van Puijenbroek, R.
Bosquee, Léon ;  Centre Hospitalier Universitaire de Liège - CHU > Pneumologie-Allergologie
Meert, A. P.
Schallier, D.
Goeminne, J. C.
Tits, G.
Collard, Philippe ;  Centre Hospitalier Universitaire de Liège - CHU > HOSPITALISATION - S.I. CORONAIRES (SI -2D)
Nackaerts, K.
Canon, J. L.
Duplaquet, F.
Galdermans, D.
Germonpré, P.
Azerad, Marie-Agnès ;  AstraZeneca > Therapeutic Area Leader > Clinical research
Vandenhoven, G.
De Greve, J.
Vansteenkiste, J.
More authors (6 more) Less
Language :
English
Title :
Gefitinib monotherapy in advanced nonsmall cell lung cancer: a large Western community implementation study
Publication date :
January 2007
Journal title :
European Respiratory Journal
ISSN :
0903-1936
eISSN :
1399-3003
Publisher :
European Respiratory Society, United Kingdom
Volume :
29
Issue :
1
Pages :
128-33
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 20 November 2018

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