Prospective phase II study of gefitinib for chemotherapy-naive patients with advanced non-small-cell lung cancer with epidermal growth factor receptor gene mutations
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PURPOSE: This study was undertaken to investigate the efficacy and the feasibility of gefitinib for chemotherapy-naïve patients with advanced non-small-cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutations. PATIENTS AND METHODS: The EGFR gene status in various tumor samples obtained from chemotherapy-naïve advanced NSCLC patients was examined by DNA sequencing of EGFR exons 18 to 23. Patients harboring EGFR mutations received gefitinib (250 mg/d) alone. The response rate, progression-free survival (PFS), and toxicity profile were assessed prospectively. RESULTS: Between June 2004 and October 2005, 75 patients were examined for the EGFR status, and 25 patients (33%) harbored EGFR mutations. EGFR mutations were significantly frequent in females (P < .01) and never or light smokers (P < .001). Sixteen patients with EGFR mutations were enrolled onto the study. The overall response rate in these patients was 75% (95% CI, 54% to 96%), and the disease control rate was 88% (95% CI, 71% to 100%). The median PFS time of these patients was 9.7 months (95% CI, 7.4 to 9.9 months). No life-threatening toxicity was observed. CONCLUSION: Treatment with gefitinib alone for chemotherapy-naïve NSCLC patients with EGFR mutations could achieve a high efficacy with acceptable toxicity. To assess the proper timing of gefitinib in such patients, a subsequent randomized trial comparing gefitinib with standard chemotherapy is warranted.
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The discovery of EGFR mutations and the dramatic responses observed with EGFR TKIs in retrospective and small phase II studies paved the way to a paradigm shift in clinical trial design, favoring development of clinically and then molecularly selected studies in NSCLC.
“The discovery of EGFR mutations and the dramatic responses observed with EGFR TKIs in retrospective and small phase II studies [20, 61, 62] paved the way to a paradigm shift in the clinical trial design, favoring the development of clinically and then molecularly selected studies in NSCLC.”
From A decade of EGFR inhibition in EGFR-mutated non small cell lung cancer (NSCLC): Old successes and future perspectives (2015) · cites this paper as [61]
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- Authors
- Inoue, A., Suzuki, T., Fukuhara, T., Maemondo, M., Kimura, Y., Morikawa, N., Watanabe, H., Saijo, Y., & Nukiwa, T.
- Affiliations
- Tohoku University (JP)
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2006-07-20
- Volume
- 24
- Issue
- 21
- Pages
- 3340-3346
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- OpenAlex
- W2093922887
- Cited by
- 509
- References
- 39
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 9 · 2022: 4 · 2021: 5 · 2020: 3 · 2019: 4 · 2018: 13 · 2017: 9 · 2016: 13 · 2015: 29 · 2014: 29 · 2013: 39 · 2012: 42
- FWCI
- 58.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
- Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Keywords
- gefitinib, non-small cell lung cancer, EGFR mutation, EGFR tyrosine kinase inhibitors, chemotherapy-naive patients, advanced non-small cell lung cancer, progression-free survival, response rate, toxicity, smoking status, sex differences
- MeSH terms
- Gefitinib, Adult, Aged, Aged, 80 and over, Alanine, Antineoplastic Agents, Arginine, Carcinoma, Non-Small-Cell Lung, Feasibility Studies, Female, Humans, Leucine, Lung Neoplasms, Male, Middle Aged, Mutation, Neoplasm Staging, Prospective Studies, Quinazolines, Treatment Outcome, Disease-Free Survival, Glutamic Acid, Positron-Emission Tomography, ErbB Receptors
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