Factors associated with a poor response to gefitinib in the NEJ002 study: smoking and the L858R mutation

Lung Cancer : Journal of the International Association for the Study of Lung Cancer
Tatsuro FukuharaToshihiro Nukiwa

Abstract

Epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) treatment is the standard therapy for non-small cell lung cancer (NSCLC) harbouring EGFR-activating mutations. The NEJ002 phase 3 clinical trial demonstrated the efficacy of EGFR-TKI; gefitinib was significantly superior in both progression-free survival (PFS) and objective response rate (ORR) than carboplatin plus paclitaxel. However, several cases showed no response. In this study, we performed further analysis of the characteristics of these non-responders. Available data from NEJ002 on maximum changes in tumour size were obtained from 103 cases (90.4%) and 110 cases (96.5%) in the carboplatin-paclitaxel and gefitinib groups, respectively. Waterfall plots of maximum tumour size changes were created for non-responders. Five (4.9%) and 9 (8.2%) cases in the carboplatin-paclitaxel and gefitinib groups were non-responders, respectively. The mean pack years of the non-responders in the carboplatin-paclitaxel and gefitinib groups were 0.33 and 31.7, respectively. The ORR of total smokers (61.5%) and heavy smokers (over 40 pack years, 52.6%) in the gefitinib group were significantly lower compared to people who have never smoked (80.0%) (P=0.044 and P=0.020, re...Continue Reading

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Citations

Feb 24, 2016·Lung Cancer : Journal of the International Association for the Study of Lung Cancer·Dandan LiHong Chen
May 5, 2017·Tumour Biology : the Journal of the International Society for Oncodevelopmental Biology and Medicine·Shaohua Cui, Liyan Jiang
Jan 18, 2018·The Cochrane Database of Systematic Reviews·Esther Ha SimKwun M Fong
May 26, 2016·The Cochrane Database of Systematic Reviews·Janette GreenhalghJohn A Green
Jul 1, 2017·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·J RemonE Felip
Dec 7, 2018·Asia-Pacific Journal of Clinical Oncology·Yoshihiko SakataKazuya Ichikado
Mar 19, 2021·The Cochrane Database of Systematic Reviews·Janette GreenhalghJohn A Green

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