title: Prospective study of second-line chemotherapy for non-small cell lung cancer selected according to EGFR gene status.
abstract: We prospectively investigated the outcome of personalized second-line treatment based on epidermal growth factor receptor (EGFR) gene status in previously treated patients with advanced non-small cell lung cancer (NSCLC). EGFR gene status was evaluable by LH-mobility shift assay in registered patients. Gefitinib (Gef) treatment was recommended if the patients had EGFR mutation (mEGFR). EGFR gene status was evaluable in 146 patients. Seventy-four of the patients were female, 82 were smokers, and 122 had adenocarcinoma. Overall, 67 patients had mEGFR and received Gef. Forty-nine of 79 patients with wild-type EGFR (wEGFR) received other chemotherapies or radiation but 30 selected best supportive care only as a second-line treatment. Patients with mEGFR survived significantly longer than patients with wEGFR (p < 0.0001). However, the survival of patients who received other forms of chemotherapy was not different from that of patients who received best supportive care only as a second-line treatment in patients with wEGFR. Examination of the association between overall survival after first-line chemotherapy and prognostic factors using multivariate regression analysis showed that mEGFR and response to first-line chemotherapy were independent factors (p = 0.003 and p = 0.003, respectively). Selection of second-line treatment according to EGFR gene status may be useful for patients with NSCLC.
authors.affiliation: Department of Thoracic Oncology, Kanagawa Cancer Center Nakao 1-1-2, Asahi-ku, Yokohama 241-0815, Japan. foshita@kcch.jp
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Oshita
authors.forename: Yohei
authors.initials: Y
authors.lastname: Miyagi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Honda
authors.forename: Shuji
authors.initials: S
authors.lastname: Murakami
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Kondo
authors.forename: Haruhiro
authors.initials: H
authors.lastname: Saito
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Noda
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yokose
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kameda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakuma
authors.forename: Masato
authors.initials: M
authors.lastname: Obata
authors.forename: Kouzo
authors.initials: K
authors.lastname: Yamada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics*; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009154:Mutation; D011446:Prospective Studies; D011799:Quinazolines / Q000627:therapeutic use*; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib