title: Retreatment of lung adenocarcinoma patients with gefitinib who had experienced favorable results from their initial treatment with this selective epidermal growth factor receptor inhibitor: a report of three cases.
abstract: Gefitinib is a selective inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinases, and shows favorable antitumor activity against chemorefractory non-small cell lung cancer (NSCLC). The majority of responders (patients who are sensitive to gefitinib), however, relapse within 1.5 years, indicating an acquired resistance to gefitinib. Here we report three chemotherapy refractory NSCLC patients who were retreated with gefitinib. All three cases were nonsmokers and showed an adenocarcinoma histology. While they had experienced successful control from their initial treatment with gefitinib for more than 12 months, gefitinib therapy was terminated because two cases (cases 1 and 3) relapsed during the therapy and case 2 suffered alveolar hemorrhage. After more than 7 months from the time of discontinuation of the initial gefitinib treatment, they were retreated with gefitinib, as further tumor progression was observed. Of the three cases, cases 1 and 2 were well controlled by retreatment with gefitinib monotherapy for more than 7 months, suggesting sensitivity to retreatment. Case 3 also showed a regression in size of several tumors, while some other lesions progressively enlarged and developed a malignant pleural effusion after 4 months. These observations suggest the possibility that retreatment with gefitinib might be useful when 1) initial treatment shows a favorable clinical response, and 2) there has been a period of time following the termination of the initial gefitinib treatment.
authors.affiliation: Department of Internal Medicine and Molecular Therapeutics, The University of Tokushima Graduate School, 3-18-15 Kuramoto-cho, Tokushima, Japan. manae@clin.med.tokushima-u.ac.jp
authors.forename: Seiji
authors.initials: S
authors.lastname: Yano
authors.forename: Emiko
authors.initials: E
authors.lastname: Nakataki
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Ohtsuka
authors.forename: Mami
authors.initials: M
authors.lastname: Inayama
authors.forename: Hideki
authors.initials: H
authors.lastname: Tomimoto
authors.forename: Nobutaka
authors.initials: N
authors.lastname: Edakuni
authors.forename: Soji
authors.initials: S
authors.lastname: Kakiuchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Nishikubo
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Muguruma
authors.forename: Saburo
authors.initials: S
authors.lastname: Sone
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy*; D000368:Aged; D000970:Antineoplastic Agents / Q000494:pharmacology*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D045744:Cell Line, Tumor; D018450:Disease Progression; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010996:Pleural Effusion; D011799:Quinazolines / Q000494:pharmacology*; D012008:Recurrence; D019233:Retreatment; D013997:Time Factors
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib