title: First-line systemic treatment with gefitinib in stage IV non-small cell lung cancer.
abstract: Lung cancer has a high mortality rate and is often diagnosed in locally advanced or metastatic stages. A new therapeutic option for patients with non-small cell lung cancer (NSCLC) in these stages with progress or relapse after platinum-based chemotherapy exists in the inhibitors of the epidermal growth factor receptor (EGFR) tyrosine-kinase. EGFR tyrosine-kinase inhibitor treatment might also be an option for patients ineligible for surgery and conventional chemotherapy. We present a case of a 53-year-old woman who was diagnosed due to pain from multiple bone metastases of a lung adenocarcinoma. She refused cytotoxic chemotherapy, and we administered first-line systemic treatment with gefitinib subsequent to radiotherapy of metastatic bone disease. The patient responded well to gefitinib treatment and achieved a partial response after 3 weeks. No relevant side effects occurred, and the patient experienced an 8-month remission of disease. With a follow-up of 10 months, the patient is still alive. Retrospectively, we found a mutation of the EGF receptor in tumor cells of the patient, which is associated with sensitivity to gefitinib. EGFR tyrosine-kinase inhibitors (TKI) can be an alternative first-line systemic treatment option for selected patients with metastatic NSCLC.
authors.affiliation: Department of Medicine, Hematology, Medical Oncology and Respiratory Medicine, University of Muenster, Albert-Schweitzer Str. 33, D-48149 Muenster, Germany. langeto@ukmuenster.de
authors.forename: Tobias
authors.initials: T
authors.lastname: Lange
authors.forename: Carsten
authors.initials: C
authors.lastname: Müller-Tidow
authors.forename: Hubert
authors.initials: H
authors.lastname: Serve
authors.forename: Petra
authors.initials: P
authors.lastname: Hoffknecht
authors.forename: Wolfgang E
authors.initials: WE
authors.lastname: Berdel
authors.forename: Michael
authors.initials: M
authors.lastname: Thomas
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001483:Base Sequence; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary; D004252:DNA Mutational Analysis; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D011799:Quinazolines / Q000627:therapeutic use*; D017384:Sequence Deletion; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib