title: Clinical responses to EGFR-tyrosine kinase inhibitor retreatment in non-small cell lung cancer patients who benefited from prior effective gefitinib therapy: a retrospective analysis.
abstract: BACKGROUND
  Gefitinib was the first epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) approved for the treatment of advanced non-small cell lung cancer (NSCLC). Few treatment options are available for NSCLC patients who have responded to gefitinib treatment and demonstrated tumor progression. The present study was conducted to evaluate the efficacy and toxicity of the 2(nd) EGFR-TKI administration.
  
  
  METHODS
  We retrospectively analyzed 11 patients who had obtained a partial response (PR) or stable disease (SD) with gefitinib treatment and were re-treated with EGFR-TKI after failure of the initial gefitinib treatment.
  
  
  RESULTS
  Three patients (27%) were treated with gefitinib as the 2(nd) EGFR-TKI, and 8 patients (73%) received erlotinib. Only one patient (9%) showed PR, 7 (64%) achieved SD, and 3 (27%) had progressive disease. The disease control rate was 73% (95% CI, 43% - 91%) and the median progression-free survival was 3.4 months (95% CI, 2 - 5.2). The median overall survival from the beginning of the 2(nd) EGFR-TKI and from diagnosis were 7.3 months (95% CI, 2.7 - 13) and 36.7 months (95% CI, 23.6 - 43.9), respectively. No statistical differences in PFS or OS were observed between gefitinib and erlotinib as the 2(nd) EGFR-TKI (PFS, P = 0.23 and OS, P = 0.052). The toxicities associated with the 2(nd) EGFR-TKI were generally acceptable and comparable to those observed for the initial gefitinib therapy.
  
  
  CONCLUSIONS
  Our results indicate that a 2(nd) EGFR-TKI treatment can be an effective treatment option for gefitinib responders.
authors.affiliation: Department of Medicine, Niigata University Medical and Dental Hospital, Niigata City, Japan. satoshimd@yahoo.co.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Watanabe
authors.forename: Junta
authors.initials: J
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ota
authors.forename: Rie
authors.initials: R
authors.lastname: Kondo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kagamu
authors.forename: Kosuke
authors.initials: K
authors.lastname: Ichikawa
authors.forename: Jun
authors.initials: J
authors.lastname: Koshio
authors.forename: Junko
authors.initials: J
authors.lastname: Baba
authors.forename: Takao
authors.initials: T
authors.lastname: Miyabayashi
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Yoshizawa
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D003967:Diarrhea / Q000139:chemically induced; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D000069347:Erlotinib Hydrochloride; D005076:Exanthema / Q000139:chemically induced; D005260:Female; D000077156:Gefitinib; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors; D000077156:Gefitinib