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Review
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Korean J Med. 2006;71(1):177-177.
- The era of post-gefitinib in NSCLC
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Sang Cheol Lee, Byeong-Bae Park, Yong Sang Hong, Sarah Park, In Gyu Hwang, Myung-Ju Ahn, Keunchil Park
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- The era of post-gefitinib in NSCLC
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, , , , , ,
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국립의료원 내과
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- Abstract
- Non-small cell lung cancer(NSCLC) is the leading cause of cancer-related death in the world. Patients most commonly present
with advanced metastatic disease that, if untreated, has a median survival of 4-5 months, and 1-year survival of less than 10%.
Most NSCLC patients are treated with palliative systemic chemotherapy because of its frequent presentation as advanced
disease. These systemic chemotherapy lead to a response in 30-40% of patients, a median survival of 8-10 months and a 1-year
survival of 30-40%. Gefitinib belongs to the small-molecular class of epidermal growth factor receptor(EGFR) tyrosine-kinase
inhibitors. Although the ISEL trial result was negative overall, preplanned subgroup analyses showed a significant overall
survival benefit for gefitinib. And so we analyzed retrospectively data from 205 patients with advanced metastatic or recurrent
NSCLC treated with gefitinib in Samsung Medical Center in Korea between 2002 and 2003. The median survival time calculated
from the date of gefitinib administration was 5.53 months with 1-year survival rate of 28.9%. The median survival time
calculated from the first diagnosis of advanced/metastatic or recurrent disease was 20.4months. Sex, adenocarcinoma histology,
smoking history, skin rash developed after the administration of gefitinib, performance status were statistically significant
favorable predictors to gefitinib treatment. This retrospective analysis suggests that gefitinib was of great benefit for patients
with never smoker, adenocarcinoma histology and skin rash developed after the administration of gefitinib. These findings are
required to be validated in further prospective clinical studies which should include the molecular predicters. Because the recent
discovery of somatic activating mutations in the EGFR tyrosine kinase domain has brought new hope of improved ability to
predict response to gefitinib.
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