First-line gefitinib therapy for elderly patients with non-small cell lung cancer harboring EGFR mutation: Central Japan Lung Study Group 0901

Takahashi, Kosuke; Saitô, Hiroshi; Hasegawa, Yoshinori; Ando, Masahiko; Yamamoto, Masashi; Kojima, Eiji; Sugino, Yasuteru; Kimura, Tomoki; Nomura, Fumio; Ogasawara, Tomohiko; Shindoh, Joe; Yoshida, Norio; Suzuki, Ritsuro

doi:10.1007/s00280-014-2548-z

Cited by 34 publications

(24 citation statements)

References 29 publications

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“…However, these clinical trials were usually conducted only or mainly in healthy patients aged 75 years or younger. In elderly patients with advanced EGFR-mutated NSCLC, some reports [13][14][15] showed the efficacy and safety of gefitinib. However, to our knowledge, the antitumor effects and safety profiles of erlotinib focused on elderly patients have not been evaluated.…”

Section: Introductionmentioning

confidence: 99%

Phase II study of erlotinib in elderly patients with non-small cell lung cancer harboring epidermal growth factor receptor mutations

Inoue

Inui

Asada

et al. 2015

Cancer Chemother Pharmacol

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Section: Introductionmentioning

confidence: 99%

Phase II study of erlotinib in elderly patients with non-small cell lung cancer harboring epidermal growth factor receptor mutations

Inoue

Inui

Asada

et al. 2015

Cancer Chemother Pharmacol

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“…Specifically, epidermal growth factor receptor (EGFR) mutations, such as exon 19 deletion and L858R point mutation, are well recognized as driver mutations and promising predictors of the efficacy of EGFR tyrosine kinase inhibitors (TKIs), such as gefitinib, erlotinib, and afatinib, in NSCLC patients harboring EGFR mutations [3][4][5][6][7]. In addition, EGFR-TKIs are recommended for elderly people [8][9][10] and they are effective regardless of the treatment timing in patients with NSCLC harboring EGFR mutations [11,12]. Recently, a large cohort study reported that gefitinib therapy resulted in a 5-year survival rate of approximately 20% in NSCLC patients harboring…”

Section: Introductionmentioning

confidence: 99%

Impact of EGFR-Tyrosine Kinase Inhibitors on Postoperative Recurrent Non-Small-Cell Lung Cancer Harboring EGFR Mutations

et al. 2017

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Background: It is unclear whether there is a difference in the efficacy of treatment by epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) between patients with postoperative recurrent non-small-cell lung cancer (NSCLC) and those with stage IV NSCLC harboring EGFR mutations. Patients and Methods: The records of NSCLC patients harboring EGFR mutations who were treated with gefitinib or erlotinib were retrospectively reviewed, and the treatment outcomes were evaluated. Moreover, we performed an immunohistochemical analysis of PD-L1 expression in tumor lesions of the postoperative recurrence group. Results: In 205 patients, both the progression-free survival (PFS) time (9.4 vs. 16.9 months) and the median survival time (24.7 vs. 37.4 months) were significantly longer in the postoperative group than in the stage IV group. Additionally, multivariate analysis identified that postoperative recurrence was an independent predictor of PFS and overall survival, as were performance status and smoking status. The PFS durations were 15.7 and 16.6 months for the high- and low-PD-L1 expression groups, respectively, and no significant difference was observed (P = 0.73). Conclusions: The findings of this study provide a valuable rationale for considering postoperative recurrence as a predictive factor for favorable PFS and overall survival in patients with NSCLC harboring activating EGFR mutations who receive EGFR-TKIs.

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“…The ORR was 70%, the disease control rate (complete response, partial response and stable disease) was 90% and the median PFS time was 10 months; the functional assessment of a cancer therapy-lung cancer subscale questionnaire recorded a significant improvement in the first four weeks of treatment, particularly for dyspnea and cough (18).…”

Section: Activity Of Gefitinib and Erlotinibmentioning

confidence: 99%

“…The majority of significant retrospective data are obtained by subgroup analysis of elderly patients from the large studies performed without age restriction (12)(13)(14). To date, a lower contribution has been provided from prospective studies specifically designed to evaluate the efficacy and safety of molecular-targeted drugs in elderly patients with NSCLC (15)(16)(17)(18)(19)(20)(21). The aim of the present review is to summarize the current data on the efficacy and safety of molecular-targeted therapy in elderly patients with advanced NSCLC.…”

Section: Introductionmentioning

confidence: 99%

Molecular-targeted therapy for elderly patients with advanced non-small cell lung cancer

et al. 2015

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Abstract. Lung cancer is the most common cause of cancer-related mortality in men and women. Non-small cell lung cancer (NSCLC) represents close to 90% of all lung cancers. When diagnosed, >50% of patients are >65 years old. Through an improved understanding of the molecular mechanisms involved in lung oncogenesis, molecular-targeted approaches have become an essential element for the treatment of patients with NSCLC. As the toxicity profiles of the techniques are definitely more favorable compared with chemotherapy, they are particularly attractive for use in elderly patients, who are potentially more susceptible to the toxicity of systemic oncological therapies. However, studies on the activity of molecular-targeted agents in this aged patient setting are much more limited compared with those in their younger counterparts. In the present review, the literature on molecular-targeted therapy for elderly patients with advanced NSCLC is discussed. It is concluded that bevacizumab should be reserved only for highly select elderly patients with advanced NSCLC when the clinician deems it useful in the face of acceptable toxicities. In elderly patients with advanced epidermal growth factor receptor mutation-positive NSCLC, erlotinib and gefitinib appear to repeat the same favorable performance as that documented on a larger scale in the overall population of patients with activating mutations. A good toxicity profile is also confirmed for active molecules on different pathways, such as crizotinib. IntroductionThe 'elderly' patient with lung cancer treated with cytotoxic chemotherapy has been the subject of several studies that have assumed international importance due to sample size, methodological rigor and impact on clinical practice. Confirmed by evidence-based medicine, these important trials have led to the definition of therapeutic standards validated in this patient subset: The ELVIS study showed the superiority of vinorelbine over placebo (1); the MILES study showed a similar effectiveness between single-agent vinorelbine or gemcitabine, and single-agent efficacy over the combination of vinorelbine plus gemcitabine (2); the MILES 2P study showed better survival for cisplatin plus gemcitabine compared with cisplatin plus vinorelbine (3); the IFCT-0501 study showed survival benefits with carboplatin plus weekly paclitaxel compared with vinorelbine or gemcitabine monotherapy (4); another study showed improved survival with platinum-based adjuvant chemotherapy (5); and in a phase II trial involving elderly patients with advanced-stage small cell lung cancer, the weekly regimen of gemcitabine and docetaxel demonstrated no advantage over standard therapy (6).The last decade of research in this field has witnessed the emergence of molecular-targeted therapies as an essential element for the treatment of patients with non-small cell lung cancer (NSCLC) (7). The studies on the activity of these novel therapies in the elderly patient with NSCLC are few (8,9), comprising a more fragmented and less numerous casuistry tha...

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First-line gefitinib therapy for elderly patients with non-small cell lung cancer harboring EGFR mutation: Central Japan Lung Study Group 0901

Abstract: First-line gefitinib therapy is effective and feasible for elderly patients harboring EGFR mutation, and improves disease-related symptoms, especially pulmonary symptoms like shortness of breath and cough.

Cited by 34 publications

References 29 publications

Phase II study of erlotinib in elderly patients with non-small cell lung cancer harboring epidermal growth factor receptor mutations

Phase II study of erlotinib in elderly patients with non-small cell lung cancer harboring epidermal growth factor receptor mutations

Impact of EGFR-Tyrosine Kinase Inhibitors on Postoperative Recurrent Non-Small-Cell Lung Cancer Harboring EGFR Mutations

Molecular-targeted therapy for elderly patients with advanced non-small cell lung cancer

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