title: Erlotinib after Gefitinib failure in female never-smoker Asian patients with pulmonary adenocarcinoma.
abstract: The activity of erlotinib after gefitinib failure in non-small cell lung cancer patients with all four favorable clinical factors including female, never smoker, Asian, and adenocarcinoma histology for tyrosine kinase inhibitors (TKIs) is not well known. Treatment efficacy of erlotinib (150mg daily) after progression on gefitinib (250mg daily) was analyzed in patients exhibiting the four clinically favorable factors. Sixteen consecutive female, never smoker, Korean (Asian), adenocarcinoma patients who received erlotinib after gefitinib failure were analyzed. The disease control rate for gefitinib was 68.8% (95% CI, 0.44-0.86) while the disease control rate for erlotinib following gefitinib failure was 25.0% (95% CI, 0.10-0.50) comprised of one partial response and three stable disease patients. The median progression free survival was 6.3 months for gefitinib treatment and 1.7 months for erlotinib treatment following gefitinib failure. The efficacy of erlotinib after progression on gefitinib is unsatisfactory in patients with four favorable clinical factors for TKIs. Novel treatment approaches such as the use of irreversible TKIs or anti-cMET agents for those patients are warranted.
authors.affiliation: Department of Internal Medicine, Seoul National University Hospital, Republic of Korea.
authors.forename: Sung Hoon
authors.initials: SH
authors.lastname: Sim
authors.forename: Sae-Won
authors.initials: SW
authors.lastname: Han
authors.forename: Do-Youn
authors.initials: DY
authors.lastname: Oh
authors.forename: Se-Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Dong-Wan
authors.initials: DW
authors.lastname: Kim
authors.forename: Seock-Ah
authors.initials: SA
authors.lastname: Im
authors.forename: Doo Hyun
authors.initials: DH
authors.lastname: Chung
authors.forename: Tae-You
authors.initials: TY
authors.lastname: Kim
authors.forename: Jong Seok
authors.initials: JS
authors.lastname: Lee
authors.forename: Young Whan
authors.initials: YW
authors.lastname: Kim
authors.forename: Dae Seog
authors.initials: DS
authors.lastname: Heo
authors.forename: Yung-Jue
authors.initials: YJ
authors.lastname: Bang
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D044466:Asian People; D004252:DNA Mutational Analysis; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm / Q000235:genetics; D066246:ErbB Receptors / Q000235:genetics; D000069347:Erlotinib Hydrochloride; D005260:Female; D000077156:Gefitinib; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D011799:Quinazolines / Q000627:therapeutic use*; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors; D000077156:Gefitinib