Evaluation of gefitinib efficacy according to body mass index, body surface area, and body weight in patients with EGFR-mutated advanced non-small cell lung cancer.
In patients with epidermal growth factor receptor (EGFR)-mutated, advanced, non-small cell lung cancer (NSCLC), common gefitinib-sensitive EGFR mutations that predict a greater response to therapy include the exon 19 deletion and L858R point mutation. The objective of this study was to evaluate whether body surface area (BSA), body weight (BW), and body mass index (BMI) affect gefitinib efficacy in such patients.



The medical charts of 138 consecutive patients with advanced NSCLC harboring sensitive EGFR mutations, who underwent gefitinib treatment, were reviewed. The median BSA and BW were used as cutoff values to evaluate their impact on gefitinib efficacy. BMI was categorized as underweight (<18.5 kg/m2), normal (18.5-25 kg/m2), and overweight (≥25 kg/m2).



The median BSA and BW were 1.48 m2and 53 kg, respectively. The overall response rate, progression-free survival (PFS), and overall survival (OS) were 65.2%, 12.2, and 24.2 months, respectively. There were no significant differences in clinical outcomes according to BSA, BW, or BMI alone. Subgroup analysis based on the mutation type and BSA revealed no significant differences in PFS between the groups; however, the median OS in those with exon 19 deletion combined with low BSA was significantly favorable compared with the other groups.



Gefitinib efficacy in patients with NSCLC harboring sensitive EGFR mutations did not differ according to BSA, BW, and BMI. However, OS was superior in patients with both the exon 19 deletion and low BSA.
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan. m06701014@gunma-u.ac.jp.|Department of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1, Takahayashi-nishi, Ohta, Gunma, 373-8550, Japan. m06701014@gunma-u.ac.jp.
Hisao
H
Imai
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.|Division of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, Japan.
Tomohito
T
Kuwako
Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, 3-39-15, Showa-machi, Maebashi, Gunma, 371-8511, Japan. kkaira1970@yahoo.co.jp.
Kyoichi
K
Kaira
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Tomomi
T
Masuda
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.|Department of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1, Takahayashi-nishi, Ohta, Gunma, 373-8550, Japan.
Yosuke
Y
Miura
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Kaori
K
Seki
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Reiko
R
Sakurai
Division of Internal Medicine, Kiryu Kosei General Hospital, Kiryu, Gunma, Japan.
Mitsuyoshi
M
Utsugi
Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Kimihiro
K
Shimizu
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Noriaki
N
Sunaga
Division of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, Japan.
Yoshio
Y
Tomizawa
Division of Internal Medicine, Isesaki Municipal Hospital, Isesaki, Gunma, Japan.
Shinichi
S
Ishihara
Division of Internal Medicine, Public Tomioka General Hospital, Tomioka, Gunma, Japan.
Takao
T
Ishizuka
Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-15, Showa-machi, Maebashi, Gunma, 371-8511, Japan.
Akira
A
Mogi
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Takeshi
T
Hisada
Department of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1, Takahayashi-nishi, Ohta, Gunma, 373-8550, Japan.
Koichi
K
Minato
Division of Respiratory Medicine, Maebashi Red Cross Hospital, Maebashi, Gunma, Japan.
Atsushi
A
Takise
Division of Respiratory Medicine, National Hospital Organization Shibukawa Medical Center, Shibukawa, Gunma, Japan.
Ryusei
R
Saito
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Masanobu
M
Yamada
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D015992:Body Mass Index; D001830:Body Surface Area; D001835:Body Weight; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics; D018572:Disease-Free Survival; D066246:ErbB Receptors / Q000037:antagonists & inhibitors / Q000235:genetics*; D005091:Exons / Q000235:genetics; D005260:Female; D000077156:Gefitinib; D017353:Gene Deletion; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D011799:Quinazolines / Q000008:administration & dosage* / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; C512478:EGFR protein, human; D066246:ErbB Receptors; D000077156:Gefitinib
Advanced non-small cell lung cancer; Body mass index; Body surface area; Body weight; EGFR mutations; Gefitinib