| Title: | Intercalated chemotherapy and erlotinib for advanced NSCLC : high proportion of complete remissions and prolonged progression-free survival among patients with EGFR activating mutations |
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| Authors: | ID Zwitter, Matjaž (Author)
ID Stanič, Karmen (Author)
ID Rajer, Mirjana (Author)
ID Kern, Izidor (Author)
ID Vrankar, Martina (Author)
ID Edelbaher, Natalija (Author)
ID Kovač, Viljem (Author) |
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| Files: |  Radiology_and_Oncology_2014_Zwitter_et_al._Intercalated_chemotherapy_and_erlotinib_for_advanced_NSCLC_high_proportion_of_complete_remiss.pdf (648,72 KB)
MD5: 9B10A61CC19AF35E9AED68C6DD1EEBD4
 http://www.degruyter.com/view/j/raon.2014.48.issue-4/raon-2014-0038/raon-2014-0038.xml
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| Language: | English |
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| Work type: | Scientific work |
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| Typology: | 1.01 - Original Scientific Article |
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| Organization: | MF - Faculty of Medicine
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| Abstract: | 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. |
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| Keywords: | non-small cell lung cancer, EGFR activating mutations, gemicitabine, erlotinib |
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| Publication status: | Published |
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| Publication version: | Version of Record |
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| Year of publishing: | 2014 |
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| Number of pages: | str. 361-368, III |
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| Numbering: | Letn. 48, št. 4 |
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| PID: | 20.500.12556/DKUM-56120  |
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| ISSN: | 1318-2099 |
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| UDC: | 616.2-006 |
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| ISSN on article: | 1318-2099 |
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| COBISS.SI-ID: | 1882747 |
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| DOI: | 10.2478/raon-2014-0038 |
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| NUK URN: | URN:SI:UM:DK:WD4XQPGU |
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| Publication date in DKUM: | 21.12.2015 |
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| Views: | 2079 |
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| Downloads: | 171 |
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| Metadata: |    |
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| Categories: | Misc.
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