Continuing EGFR-TKI treatment in combination with super-selective arterial infusion chemotherapy beyond disease progression for patients with advanced EGFR-mutant non-small cell lung cancer.
Regional therapy has shown promising results in patients with an oligo-metastasis after the occurrence of resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). This study evaluated the efficacy and safety of continuing EGFR-TKI therapy concurrently with arterial infusion chemotherapy in 6 patients (median age 55.9 years) with advanced EGFR-mutant non-small cell lung cancer (NSCLC) who had a locally progressive, centrally located lung lesion after EGFR-TKI therapy. The patients received a super-selective arterial infusion of docetaxel (75 mg/m(2)) every 28 days concurrently with EGFR-TKI therapy until further progressive disease (PD) or unacceptable adverse effects (AEs) occurred. Treatment outcomes were assessed via progression-free survival (PFS) times (PFS-1: time to PD after EGFR-TKI therapy; PFS-2: time to further PD after arterial infusion chemotherapy with EGFR-TKI therapy), the occurrence of treatment-related AEs, and patient responses to the QLQ-LC13 quality-of-life questionnaire. Three of the 6 patients achieved partial responses, and three had stable disease. The median PFS-1 was 10.42 months, and the median PFS-2 was 4.1 months (range, 2.1-5.7 months). The median overall survival (OS) was 28.6 months (range, 24.1-32.9 months). All AEs were either grade 1 or grade 2 in severity, and no unexpected AEs were observed. One patient died of lung cancer. The patients reported significant reductions from baseline in symptoms of cough, chest pain, dyspnea, and hemoptysis (P < 0.05 for all comparisons). Thus, continuing EGFR-TKI therapy in combination with super-selective arterial infusion chemotherapy beyond PD for patients with advanced EGFR-mutant NSCLC is feasible, and this approach warrants further investigation.
Department of Oncology, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, 507, Zhengmin Road, Shanghai, 200433, China. Huiwei_queen@163.com.
Huiwei
H
Qi
Department of Radiology, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China. Jasfly77@vip.163.com.
Sen
S
Jiang
Department of Radiology, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, Shanghai, China. Yudong_mail@126.com.
Dong
D
Yu
Department of Oncology, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, 507, Zhengmin Road, Shanghai, 200433, China. Bj20021120@163.com.
Huijuan
H
Ni
Department of Oncology, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, 507, Zhengmin Road, Shanghai, 200433, China. 13601919755@163.com.
Qiong
Q
Hu
Department of Oncology, Shanghai Pulmonary Hospital, Tongji University, School of Medicine, 507, Zhengmin Road, Shanghai, 200433, China. zhangjie2172@163.com.
Jie
J
Zhang
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics; D000077143:Docetaxel; D066246:ErbB Receptors / Q000037:antagonists & inhibitors*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000009:adverse effects; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D043823:Taxoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D043823:Taxoids; D000077143:Docetaxel; D066246:ErbB Receptors
Arterial infusion chemotherapy; Docetaxel; Non-small cell lung cancer; Progressive disease; Tyrosine kinase inhibitors