Efficacy analysis of gefitinib in the first-line and the second-line treatment of advanced non-small cell lung cancer with different mutations of epidermal growth factor receptor / 肿瘤研究与临床

ABSTRACT

Objective To analyze the efficacy of gefitinib in the first-line and the second-line treatment of advanced non-small cell lung cancer (NSCLC) with different mutations of epidermal growth factor receptor (EGFR). Methods The clinical data of 70 patients with advanced NSCLC harboring different EGFR mutations and taking gefitinib as the first-line or the second-line treatment in Shanxi Provincial Cancer Hospital from January 2013 to December 2014 was analyzed retrospectively. According to the treatment method, the patients were divided into the first-line treatment group (36 cases) and the second-line treatment group (34 cases); according to the type of gene mutations, the patients were divided into exon 19 deletion group (EGFR gene exon 19 LREA deletion, 46 cases) and exon 21 mutation group (exon 21 L858R mutation, 24 cases). Progression-free survival (PFS), effective rate (ORR), and disease control rate (DCR) were observed in each group. Results Of the 70 evaluable patients, the median PFS time in patients with exon 19 LREA deletion was 8.88 months (95％ CI 7.72-10.04), and the median PFS time in patients with exon 21 L858R mutation was 8.67 months (95％ CI 7.17-10.17), the difference between the two groups was not statistically significant (P = 0.959). The ORR in patients with exon 19 LREA deletion was 69.6％ (32/46), and the ORR inpatients with exon 21 L858R mutation was 54.2％ (13/24), the difference was not statistically significant (χ 2= 1.629, P = 0.202). The DCR in patients with exon 19 LREA deletion was 84.8％ (39/46), and the DCR in patients with exon 21 L858R mutation was 91.7％ (22/24), the difference was not statistically significant (χ 2= 0.194, P = 0.659). The median PFS time in patients with the first-line treatment was 9.22 months (95％ CI 7.92-10.52), and the median PFS time in patients with the second-line treatment was 8.37 months (95％ CI 7.08-9.65), the difference was not statistically significant (P = 0.507). The ORR in patients with the first-line treatment was 63.9％ (23/36), and the ORR in patients with the second-line treatment was 58.8％ (20/34), the difference was not statistically significant (χ 2 = 1.460, P = 0.227). The DCR in patients with the first-line treatment was 88.9％ (32/36), and the DCR in patients with the second-line treatment was 88.2％ (30/34), the difference was not statistical significant (χ 2 = 0.060, P = 0.940). Conclusion The short-term efficacy and PFS are similar between NSCLC patients with different mutations of EGFR or with the first-line and the second-line treatment with gefitinib.