title: Skin rash as a surrogate marker of clinical response of targeted therapy using gefitinib in advanced or metastatic non-small-cell lung cancer--a retrospective study.
abstract: This retrospective review of a single institution case series study was conducted to correlate the objective response and skin rash of gefitinib in patients with advanced or metastatic non-small-cell lung cancer(NSCLC). One hundred and forty-nine patients with advanced or metastatic NSCLC were treated with gefitinib (250 mg/day) as second line systemic therapy. Baseline patient characteristics were: More than 75% patients were above 50 years of age, males 64%; adenocarcinoma 52%. Sixty-one patients were excluded from the analysis due to varying reasons; only 88 remaining in the analysis. Partial response was observed in 15 patients (17%), and 34 patients (38.6%) had stable disease. The rest 39 patients (44.3%) had progressive disease on gefitinib therapy. There was a significantly longer median time to progression (TTP) of 7 months in females as compared to 5 months in males (p = 0.001). A highly significant association (p = 0.001) was observed between the grade of skin toxicity and the median time to disease progression, with the median TTP being 4 months in patients experiencing no skin toxicity as compared to 7 months with those grade 2 skin toxicity and 12 months with grade 3 skin toxicity. Gender (p = 0.003), and presence of skin toxicity (p = 0.0001) were having significant difference in median overall survival. On multivariate testing of the same using Cox regression analysis only presence of skin toxicity (p = 0.012) and gender (p = 0.003) was found to significant factors. Thus it can be concluded that occurrence of skin rash and female gender were associated with improved survival with gefitinib for recurrent NSCLC patients.
authors.affiliation: Bankura Sammilani Medical College, Bankura 722102.
authors.forename: Santanu
authors.initials: S
authors.lastname: Acharyya
authors.forename: Sourav
authors.initials: S
authors.lastname: Sau
authors.forename: Partha
authors.initials: P
authors.lastname: Dasgupta
authors.forename: Amitava
authors.initials: A
authors.lastname: Chakraborty
authors.forename: Subir
authors.initials: S
authors.lastname: Gangopadhyay
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015415:Biomarkers; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018450:Disease Progression; D018572:Disease-Free Survival; D003875:Drug Eruptions / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality; D019008:Drug Resistance, Neoplasm; D005260:Female; D005500:Follow-Up Studies; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009367:Neoplasm Staging; D011379:Prognosis; D011799:Quinazolines / Q000009:adverse effects* / Q000627:therapeutic use; D019233:Retreatment; D012189:Retrospective Studies; D012737:Sex Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D015415:Biomarkers; D011799:Quinazolines; D000077156:Gefitinib