title: Continued treatment with gefitinib beyond progressive disease benefits patients with activating EGFR mutations.
abstract: BACKGROUND
  Gefitinib is an effective treatment for patients with non-small cell lung cancer who harbor activating epidermal growth factor receptor (EGFR) mutations. However, no optimal strategy has been established for these patients after gefitinib fails. The aim of this retrospective study was to assess the survival benefit of continued gefitinib treatment in these cases.
  
  
  METHODS
  We analyzed gefitinib responders with activating EGFR mutations who developed progressive disease (PD) during the course of therapy. Prognostic variables were analyzed using a Cox proportional-hazards model.
  
  
  RESULTS
  A total of 134 patients were retrospectively reviewed. Exon-19 deletion mutations and L858R point mutations were detected in 71 and 63 patients, respectively. Median survival time after PD with gefitinib was 14.3 months (95% confidence interval: 11.7-16.9). The median duration of continued gefitinib therapy beyond PD was 3.2 months. Statistical analysis showed that good performance status (0-1) (hazard ratio [HR]: 0.6), progression of a previously evaluated lesion (HR: 0.6), and at least 3 months of continued treatment (HR: 0.4) were independent prognostic factors.
  
  
  CONCLUSIONS
  Continuation of gefitinib beyond PD is an effective optional treatment in EGFR-mutated patients.
authors.affiliation: Department of Clinical Oncology, National Hospital Organization Kinki-Chuo Chest Medical Center, Sakai, Japan. kazu.taizo@nifty.com
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Asami
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Okuma
authors.forename: Tomonori
authors.initials: T
authors.lastname: Hirashima
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kawahara
authors.forename: Shinji
authors.initials: S
authors.lastname: Atagi
authors.forename: Tomoya
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Okishio
authors.forename: Naoki
authors.initials: N
authors.lastname: Omachi
authors.forename: Naoko
authors.initials: N
authors.lastname: Takeuchi
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D018450:Disease Progression; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008297:Male; D009154:Mutation; D011799:Quinazolines / Q000008:administration & dosage* / Q000009:adverse effects; D012189:Retrospective Studies; D016019:Survival Analysis; D017211:Treatment Failure
chemical_list: D011799:Quinazolines; C512478:EGFR protein, human; D066246:ErbB Receptors; D000077156:Gefitinib