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The administration of gefitinib in patients with advanced non-small-cell lung cancer after the failure of erlotinib

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Abstract

Purpose

Recent studies have demonstrated that erlotinib therapy may be considered an option for patients with advanced non-small-cell lung cancer who experienced disease progression after treatment with gefitinib, particularly in patients in whom the disease had been stabilized for a long time prior to gefitinib therapy. The aim of this study was to evaluate the disease control rate and toxicity of gefitinib in patients whose disease progressed after erlotinib therapy.

Methods

From May 2005 to August 2006, 15 patients received a 250 mg/day dosage of gefitinib after having disease progression while taking erlotinib at a dose of 150 mg/day.

Results

Among patients who received erlotinib, 1 (7%) achieved a partial response (PR), and 5 (33%) achieved stable disease (SD). Among patients who received gefitinib, none achieved a PR, and 6 achieved SD (40%). Five out of 6 patients who achieved PR/SD with erlotinib also achieved SD with gefitinib; 8 out of 9 patients who achieved a progressive disease (PD) with erlotinib also achieved a PD with gefitinib. The median time to progression (TTP) and overall survival (OS) were 2.3 and 3.5 months, respectively. The TTP and OS in SD patients were 3.7 and 7.4 months, respectively. The most common toxicities of gefitinib were dry skin (grade 1–2) in 27% of patients and acneiform rashes and rashes/desquamation in 20% of patients. Diarrhea (grade 1–2) occurred in 7% of patients.

Conclusions

Our data suggest that patients who achieved PR/SD with erlotinib also benefit from taking gefitinib. Conversely, gefitinib is not recommended in patients whose disease progressed after taking erlotinib.

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Conflict of interest

Francesco Grossi received an honorarium to serve on scientific meetings of Roche and Astra-Zeneca. The other co-authors have not conflict of interest to declare.

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Authors and Affiliations

  1. S.S. Tumori Polmonari, Istituto Nazionale per la Ricerca sul Cancro, L.go Benzi, 10, 16132, Genoa, Italy

    Francesco Grossi, Erika Rijavec, Maria Giovanna Dal Bello, Carlotta Defferrari, Annalisa Brianti, Giulia Barletta & Carlo Genova

  2. S.C. Diagnostica per immagini ed interventistica oncologica, Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy

    Carmelina Murolo & Maurizio Cosso

  3. Sezione Anatomia Patologica, Dipartimento di Chirurgia Università di Pisa, Pisa, Italy

    Gabriella Fontanini & Laura Boldrini

  4. S.C. Anatomia e Citoistologia patologica, Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy

    Mauro Truini

  5. S.C. Oncologia Medica A, Istituto Nazionale per la Ricerca sul Cancro, Genoa, Italy

    Paolo Pronzato

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  1. Francesco Grossi
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  2. Erika Rijavec
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Correspondence to Francesco Grossi.

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Grossi, F., Rijavec, E., Dal Bello, M.G. et al. The administration of gefitinib in patients with advanced non-small-cell lung cancer after the failure of erlotinib. Cancer Chemother Pharmacol 69, 1407–1412 (2012). https://doi.org/10.1007/s00280-012-1848-4

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  • DOI: https://doi.org/10.1007/s00280-012-1848-4

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