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Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 9/2015

01-09-2015 | Research Article

Efficacy of platinum combination chemotherapy after first-line gefitinib treatment in non-small cell lung cancer patients harboring sensitive EGFR mutations

Authors: T. Masuda, H. Imai, T. Kuwako, Y. Miura, R. Yoshino, K. Kaira, K. Shimizu, N. Sunaga, Y. Tomizawa, S. Ishihara, A. Mogi, T. Hisada, K. Minato, A. Takise, R. Saito, M. Yamada

Published in: Clinical and Translational Oncology | Issue 9/2015

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Abstract

Purpose

Gefitinib is an effective first-line chemotherapy for advanced non-small cell lung cancer (NSCLC) patients harboring sensitive EGFR mutations. However, whether second-line platinum combination chemotherapy after first-line gefitinib treatment shows similar effects to first-line platinum combination chemotherapy in these patients remains unclear. Therefore, we here aimed to investigate the efficacy of platinum combination chemotherapy after first-line gefitinib treatment in NSCLC patients harboring sensitive EGFR mutations.

Methods/patients

We retrospectively evaluated the clinical effects of second-line platinum combination chemotherapy after first-line gefitinib treatment in NSCLC patients harboring sensitive EGFR mutations (exon 19 deletion or exon 21 L858R mutation) at five institutions. All patients were initially treated with gefitinib (250 mg/day) followed by platinum combination chemotherapy as second-line chemotherapy.

Results

Between January 2006 and December 2012, 42 patients [8 men, 34 women; median age, 63 years (range 39–75 years)] were enrolled. The overall response rate, disease control rate, and median progression-free survival (PFS) were 26.2, 61.9 %, and 5.1 months, respectively, after the second-line treatment. The corresponding values for first-line gefitinib treatment were 69.0, 95.2 %, and 11.1 months, respectively. Moreover, second-line platinum combination chemotherapy with pemetrexed or bevacizumab-containing regimens was independently associated with improved PFS.

Conclusions

Second-line platinum combination chemotherapy after first-line gefitinib treatment in NSCLC patients harboring sensitive EGFR mutations was effective and showed equivalent outcomes to first-line platinum combination chemotherapy. After failure of first-line gefitinib therapy, second-line platinum combination chemotherapy with pemetrexed or bevacizumab might result in improved PFS.
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Metadata
Title
Efficacy of platinum combination chemotherapy after first-line gefitinib treatment in non-small cell lung cancer patients harboring sensitive EGFR mutations
Authors
T. Masuda
H. Imai
T. Kuwako
Y. Miura
R. Yoshino
K. Kaira
K. Shimizu
N. Sunaga
Y. Tomizawa
S. Ishihara
A. Mogi
T. Hisada
K. Minato
A. Takise
R. Saito
M. Yamada
Publication date
01-09-2015
Publisher
Springer Milan
Published in
Clinical and Translational Oncology / Issue 9/2015
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-015-1297-8

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