title: Gefitinib treatment in patients with postoperative recurrent non-small-cell lung cancer harboring epidermal growth factor receptor gene mutations.
abstract: BACKGROUND
  The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor gefitinib is an effective treatment for recurrent or advanced lung cancer harboring EGFR gene mutations, and has improved progression-free survival in several clinical trials. However, the effect of gefitinib treatment for recurrent lung cancers with EGFR gene mutations after complete resection and the influence of the timing of such treatment have not been fully elucidated in a practical setting.
  
  
  METHODS
  We investigated 64 patients (median age: 68 years; men: 22; women: 42; adenocarcinoma: 61; adenosquamous cell carcinoma: 2; combined large cell neuroendocrine carcinoma: 1) with recurrent lung cancer after complete resection who received gefitinib for the recurrent lesions and in whom the tumors had EGFR gene mutations. Progression-free survival, response rate, and safety were analyzed.
  
  
  RESULTS
  Complete response and partial response were achieved in 2 patients and in 42 patients, respectively (objective response rate: 69 %). Stable disease was obtained in 16 patients, the disease control rate was 94 %, and median progression-free survival was 16 months. The timing of gefitinib treatment (first line, second line, or later) and the type of EGFR gene mutation present did not influence progression-free survival. However, a smaller number of recurrent sites at the start of gefitinib treatment was linked to better progression-free survival. Hematologic and nonhematologic toxicities were generally mild, but 1 patient experienced interstitial lung disease.
  
  
  CONCLUSIONS
  Our results suggest that gefitinib treatment for recurrent lung cancer with gene EGFR mutations is a useful option in a practical setting, irrespective of the timing of such treatment and the type of EGFR gene mutation present.
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Shogoin-Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Shogoin-Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan. mysonobe@kuhp.kyoto-u.ac.jp.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sonobe
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Shogoin-Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Tetsu
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Shogoin-Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Sato
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Shogoin-Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Toshi
authors.initials: T
authors.lastname: Menju
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Shogoin-Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Aoyama
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Shogoin-Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Shogoin-Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Fengshi
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Shogoin-Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Mitsugu
authors.initials: M
authors.lastname: Omasa
authors.affiliation: Department of Thoracic Surgery, Kyoto University Hospital, Shogoin-Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Date
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000235:genetics / Q000556:secondary / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D018196:Carcinoma, Adenosquamous / Q000188:drug therapy / Q000235:genetics / Q000556:secondary / Q000601:surgery; D018287:Carcinoma, Large Cell / Q000188:drug therapy / Q000235:genetics / Q000556:secondary / Q000601:surgery; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000556:secondary / Q000601:surgery; 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 / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000235:genetics; D011184:Postoperative Period; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib
keywords: Epidermal growth factor receptor; Gefitinib; Lung cancer; Postoperative recurrence