20.500.12556/DKUM-56120 Intercalated chemotherapy and erlotinib for advanced NSCLC high proportion of complete remissions and prolonged progression-free survival among patients with EGFR activating mutations Background: Pharmaco-dynamic separation of cytotoxic and targeted drugs might avoid their mutual antagonistic effect in the treatment of advanced non-small cell lung cancer (NSCLC). Patients and methods: Eligible patients were treatment-naive with stage IIIB or IV NSCLC. In addition, inclusion was limited to never-smokers or light smokers or, after 2010, to patients with activating epidermal growth-factor receptor (EGFR) mutations. Treatment started with 3-weekly cycles of gemcitabine and cisplatin on days 1, 2 and 4 and erlotinib on days 5 to 15. After 4 to 6 cycles, patients continued with erlotinib maintenance. Results: Fifty-three patients were recruited into the trial: 24 prior to 2010 (of whom 9 were later found to be positive for EGFR mutations), and 29 EGFR mutation-positive patients recruited later. Unfavourable prognostic factors included stage IV disease (51 patients - 96%), performance status 2%3 (11 patients - 21%) and brain metastases (15 patients - 28%). Grade 4 toxicity included 2 cases of neutropenia and 4 thrombo-embolic events. The 15 EGFR negative patients had 33% objective response rate, median progression-free survival (PFS) 6.0 months and median survival 7.6 months. Among 38 EGFR positive patients, complete response (CR) or partial response (PR) were seen in 16 (42.1%) and 17 (44.7%) cases, respectively. PET-CT scanning was performed in 30 patients and confirmed CR and PR in 16 (53.3%) and 9 (30.0%) cases, respectively. Median PFS for EGFR mutated patients was 21.2 months and median survival was 32.5 months. Conclusions: While patients with EGFR negative tumors do not benefit from addition of erlotinib, the intercalated schedule appears most promising for those with EGFR activating mutations. non-small cell lung cancer EGFR activating mutations gemicitabine erlotinib nedrobnocelični rak pljučni rak gemicitabin cisplatin true false true Angleški jezik Slovenski jezik Znanstveno delo 2015-12-21 16:34:26 2015-12-21 16:34:26 2022-06-11 03:08:12 2021-05-15 03:27:54 2014 0 0 str. 361-368, III št. 4 Letn. 48 Dec. 2014 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 1318-2099 616.2-006 32649472 1882747 10.2478/raon-2014-0038 1318-2099 URN:SI:UM:DK:WD4XQPGU Radiology_and_Oncology_2014_Zwitter_et_al._Intercalated_chemotherapy_and_erlotinib_for_advanced_NSCLC_high_proportion_of_complete_remiss.pdf Radiology_and_Oncology_2014_Zwitter_et_al._Intercalated_chemotherapy_and_erlotinib_for_advanced_NSCLC_high_proportion_of_complete_remiss.pdf 1 9B10A61CC19AF35E9AED68C6DD1EEBD4 096add40186e61e1625a4052d0c37187c960e21dff6fece1dccc8c9604fd0f84 1132a0ba-7c0e-11eb-bb7a-00155d0001ca https://dk.um.si/Dokument.php?lang=slv&id=110641 http://www.degruyter.com/view/j/raon.2014.48.issue-4/raon-2014-0038/raon-2014-0038.xml 1 https://dk.um.si/Dokument.php?lang=slv&id=110642 Medicinska fakulteta 0 0 0