title: The administration of gefitinib in patients with advanced non-small-cell lung cancer after the failure of erlotinib.
abstract: OBJECTIVE
  Recent studies have demonstrated that erlotinib therapy may be considered an option for patients with advanced non-small-cell lung cancer who experienced disease progression after treatment with gefitinib, particularly in patients in whom the disease had been stabilized for a long time prior to gefitinib therapy. The aim of this study was to evaluate the disease control rate and toxicity of gefitinib in patients whose disease progressed after erlotinib therapy.
  
  
  METHODS
  From May 2005 to August 2006, 15 patients received a 250 mg/day dosage of gefitinib after having disease progression while taking erlotinib at a dose of 150 mg/day.
  
  
  RESULTS
  Among patients who received erlotinib, 1 (7%) achieved a partial response (PR), and 5 (33%) achieved stable disease (SD). Among patients who received gefitinib, none achieved a PR, and 6 achieved SD (40%). Five out of 6 patients who achieved PR/SD with erlotinib also achieved SD with gefitinib; 8 out of 9 patients who achieved a progressive disease (PD) with erlotinib also achieved a PD with gefitinib. The median time to progression (TTP) and overall survival (OS) were 2.3 and 3.5 months, respectively. The TTP and OS in SD patients were 3.7 and 7.4 months, respectively. The most common toxicities of gefitinib were dry skin (grade 1-2) in 27% of patients and acneiform rashes and rashes/desquamation in 20% of patients. Diarrhea (grade 1-2) occurred in 7% of patients.
  
  
  CONCLUSIONS
  Our data suggest that patients who achieved PR/SD with erlotinib also benefit from taking gefitinib. Conversely, gefitinib is not recommended in patients whose disease progressed after taking erlotinib.
authors.affiliation: S.S. Tumori Polmonari, Istituto Nazionale per la Ricerca sul Cancro, L.go Benzi, 10, 16132, Genoa, Italy. francesco.grossi@istge.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Grossi
authors.forename: Erika
authors.initials: E
authors.lastname: Rijavec
authors.forename: Maria Giovanna
authors.initials: MG
authors.lastname: Dal Bello
authors.forename: Carlotta
authors.initials: C
authors.lastname: Defferrari
authors.forename: Annalisa
authors.initials: A
authors.lastname: Brianti
authors.forename: Giulia
authors.initials: G
authors.lastname: Barletta
authors.forename: Carlo
authors.initials: C
authors.lastname: Genova
authors.forename: Carmelina
authors.initials: C
authors.lastname: Murolo
authors.forename: Maurizio
authors.initials: M
authors.lastname: Cosso
authors.forename: Gabriella
authors.initials: G
authors.lastname: Fontanini
authors.forename: Laura
authors.initials: L
authors.lastname: Boldrini
authors.forename: Mauro
authors.initials: M
authors.lastname: Truini
authors.forename: Paolo
authors.initials: P
authors.lastname: Pronzato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality; D018450:Disease Progression; D000069347:Erlotinib Hydrochloride; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D017211:Treatment Failure
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D000069347:Erlotinib Hydrochloride; D000077156:Gefitinib