title: Effect of gefitinib challenge to initial treatment with non-small cell lung cancer.
abstract: OBJECTIVE
  This study was conducted to assess the efficacy and toxicity of gefitinib as first line treatment in patients with advanced non-small-cell lung cancer (NSCLC).
  
  
  METHODS
  Tumor tissue, derived from either the original tumor or the metastatic or recurrent site was taken from chemo-naïve patients with advanced (stage IIIB, IV and recurrent) NSCLC. Tumor genomic DNA underwent direct sequencing for EGFR exons 18, 19, 20 and 21. Sixty-one patients received 250mg of gefitinib daily until disease progression or unacceptable toxicity.
  
  
  RESULTS
  Out of 61 patients, 26 patients (42.6%) were EGFR mutations and 11 patients were wild type, 24 patients were status unknown. One patient achieved complete remission (CR). While 17 patients achieved partial remission (PR) and 23 experienced stable disease (SD). There were 20 patients developed progressive disease (PD). The tumor response rate and disease control rate was 29.5 and 67.2%, respectively, and symptom remission rate was 66.7% as well. Median remission time was 9 days. Median over survival time was 13.0 months. Median progression-free survival time was 5.0 months. The MST of patients with EGFR mutation was 17.0 months, while the MST of patients with EGFR status unknown or wild type was 11.0 months. The PFS of patients with EGFR mutation was 9.0 months and it in EGFR status unknown or wild type was 2.5 months .The most common toxicity included rash (54.1%) and diarrhea (31.1%). Dehydration and pruritus of skin was observed in 31.1 and 26.2% of the patients respectively. Hepatic toxicity occurred in 8.2% of patients and oral ulceration occurred in six patients (9.8%).
  
  
  CONCLUSIONS
  Single agent treatment with gefitinib is effective in patients with advanced NSCLC, especially in patients with EGFR mutation, and well tolerated in Chinese patients.
authors.affiliation: Department of Oncology, the First Affiliated Hospital of Nanjing Medical University, Guangzhou Road #300, 210029 Nanjing, PR China.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Chen
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Hu
authors.forename: Yiting
authors.initials: Y
authors.lastname: Geng
authors.forename: Rong
authors.initials: R
authors.lastname: Wang
authors.forename: Yongmei
authors.initials: Y
authors.lastname: Yin
authors.forename: Yongqian
authors.initials: Y
authors.lastname: Shu
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D002681:China; D004273:DNA, Neoplasm; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009367:Neoplasm Staging; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D012074:Remission Induction; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D004273:DNA, Neoplasm; D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib