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Title:Intercalated chemotherapy and erlotinib for advanced NSCLC : high proportion of complete remissions and prolonged progression-free survival among patients with EGFR activating mutations
Authors:ID Zwitter, Matjaž (Author)
ID Stanič, Karmen (Author)
ID Rajer, Mirjana (Author)
ID Kern, Izidor (Author)
ID Vrankar, Martina (Author)
ID Edelbaher, Natalija (Author)
ID Kovač, Viljem (Author)
Files:.pdf PDF - Presentation file, download (590,54 KB)
MD5: 4D15D54FD12A329B5D885D617B42F63C
 
Language:English
Typology:1.01 - Original Scientific Article
Organization:Logo OI - Institute of Oncology
Abstract:Background. Pharmaco-dynamic separation of cytotoxic and targeted drugs might avoid their mutual antagonistic effect in the treatment of advanced non-small cell lung cancer (NSCLC). Patients and methods. Eligible patients were treatment-naive with stage IIIB or IV NSCLC. In addition, inclusion was limited to never-smokers or light smokers or, after 2010, to patients with activating epidermal growth-factor receptor (EGFR) mutations. Treatment started with 3-weekly cycles of gemcitabine and cisplatin on days 1, 2 and 4 and erlotinib on days 5 to 15. After 4 to 6 cycles, patients continued with erlotinib maintenance. Results. Fifty-three patients were recruited into the trial: 24 prior to 2010 (of whom 9 were later found to be positive for EGFR mutations), and 29 EGFR mutation-positive patients recruited later. Unfavourable prognostic factors included stage IV disease (51 patients - 96%), performance status 2%3 (11 patients - 21%) and brain metastases (15 patients - 28%). Grade 4 toxicity included 2 cases of neutropenia and 4 thrombo-embolic events. The 15 EGFR negative patients had 33% objective response rate, median progression-free survival (PFS) 6.0 months and median survival 7.6 months. Among 38 EGFR positive patients, complete response (CR) or partial response (PR) were seen in 16 (42.1%) and 17 (44.7%) cases, respectively. PET-CT scanning was performed in 30 patients and confirmed CR and PR in 16 (53.3%) and 9 (30.0%) cases, respectively. Median PFS for EGFR mutated patients was 21.2 months and median survival was 32.5 months. Conclusions. While patients with EGFR negative tumors do not benefit from addition of erlotinib, the intercalated schedule appears most promising for those with EGFR activating mutations.
Keywords:non-small cell lung cancer, EGFR activating mutations, gemicitabine, erlotinib
Publication status:Published
Publication version:Version of Record
Publication date:01.12.2014
Publisher:Association of Radiology and Oncology
Year of publishing:2014
Number of pages:str. 361-368, III
Numbering:Vol. 48, no. 4
Source:Ljubljana
PID:20.500.12556/DiRROS-18669 New window
UDC:616.2-006
ISSN on article:1318-2099
DOI:10.2478/raon-2014-0038 New window
COBISS.SI-ID:1882747 New window
Copyright:by Authors
Publication date in DiRROS:11.04.2024
Views:723
Downloads:225
Metadata:XML DC-XML DC-RDF
:
ZWITTER, Matjaž, STANIČ, Karmen, RAJER, Mirjana, KERN, Izidor, VRANKAR, Martina, EDELBAHER, Natalija and KOVAČ, Viljem, 2014, Intercalated chemotherapy and erlotinib for advanced NSCLC : high proportion of complete remissions and prolonged progression-free survival among patients with EGFR activating mutations. Radiology and oncology [online]. 2014. Vol. 48, no. 4, p. 361–368, iii. [Accessed 10 April 2025]. DOI 10.2478/raon-2014-0038. Retrieved from: https://dirros.openscience.si/IzpisGradiva.php?lang=eng&id=18669
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Record is a part of a journal

Title:Radiology and oncology
Shortened title:Radiol. oncol.
Publisher:Slovenian Medical Society - Section of Radiology, Croatian Medical Association - Croatian Society of Radiology
ISSN:1318-2099
COBISS.SI-ID:32649472 New window

Secondary language

Language:Slovenian
Keywords:nedrobnocelični rak, pljučni rak, gemicitabin, cisplatin


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