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Efficacy and safety of cytotoxic drug chemotherapy after first-line EGFR-TKI treatment in elderly patients with non-small-cell lung cancer harboring sensitive EGFR mutations.
Cancer Chemother Pharmacol 2018; 82(1):119-127CC

Abstract

PURPOSE

Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) is effective as first-line chemotherapy for patients with advanced non-small-cell lung cancer (NSCLC) harboring sensitive EGFR mutations. However, whether the efficacy of second-line cytotoxic drug chemotherapy after first-line EGFR-TKI treatment is similar to that of first-line cytotoxic drug chemotherapy in elderly patients aged ≥ 75 years harboring sensitive EGFR mutations is unclear. Therefore, we aimed to investigate the efficacy and safety of cytotoxic drug chemotherapy after first-line EGFR-TKI treatment in elderly patients with NSCLC harboring sensitive EGFR mutations.

METHODS

We retrospectively evaluated the clinical effects and safety profiles of second-line cytotoxic drug chemotherapy after first-line EGFR-TKI treatment in elderly patients with NSCLC harboring sensitive EGFR mutations (exon 19 deletion/exon 21 L858R mutation). Between April 2008 and December 2015, 78 elderly patients with advanced NSCLC harboring sensitive EGFR mutations received first-line EGFR-TKI at four Japanese institutions. Baseline characteristics, regimens, responses to first- and second-line treatments, whether or not patients received subsequent treatment, and if not, the reasons for non-administration were recorded.

RESULTS

Overall, 20 patients with a median age of 79.5 years (range 75-85 years) were included in our analysis. The overall response, disease control, median progression-free survival, and overall survival rates were 15.0, 60.0%, 2.4, and 13.2 months, respectively. Common adverse events included leukopenia, neutropenia, anemia, thrombocytopenia, malaise, and anorexia. Major grade 3 or 4 toxicities included leukopenia (25.0%) and neutropenia (45.0%). No treatment-related deaths were noted.

CONCLUSION

Second-line cytotoxic drug chemotherapy after first-line EGFR-TKI treatment among elderly patients with NSCLC harboring sensitive EGFR mutations was effective and safe and showed equivalent outcomes to first-line cytotoxic drug chemotherapy.

Authors+Show Affiliations

Division of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1, Takahayashinishi, Ota, Gunma, 373-8550, Japan. m06701014@gunma-u.ac.jp.Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan.Division of Thoracic Oncology, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan.Division of Respiratory Medicine, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan.Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.Department of Pulmonary Medicine, Fukushima Medical University, Fukushima, Japan. Clinical Oncology Center, Fukushima Medical University Hospital, Fukushima, Japan.Division of Thoracic Oncology, Tochigi Cancer Center, Utsunomiya, Tochigi, Japan.Division of Respiratory Medicine, Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan.Division of Respiratory Medicine, Gunma Prefectural Cancer Center, 617-1, Takahayashinishi, Ota, Gunma, 373-8550, Japan.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

29737372

Citation

Imai, Hisao, et al. "Efficacy and Safety of Cytotoxic Drug Chemotherapy After First-line EGFR-TKI Treatment in Elderly Patients With Non-small-cell Lung Cancer Harboring Sensitive EGFR Mutations." Cancer Chemotherapy and Pharmacology, vol. 82, no. 1, 2018, pp. 119-127.
Imai H, Minemura H, Sugiyama T, et al. Efficacy and safety of cytotoxic drug chemotherapy after first-line EGFR-TKI treatment in elderly patients with non-small-cell lung cancer harboring sensitive EGFR mutations. Cancer Chemother Pharmacol. 2018;82(1):119-127.
Imai, H., Minemura, H., Sugiyama, T., Yamada, Y., Kaira, K., Kanazawa, K., ... Minato, K. (2018). Efficacy and safety of cytotoxic drug chemotherapy after first-line EGFR-TKI treatment in elderly patients with non-small-cell lung cancer harboring sensitive EGFR mutations. Cancer Chemotherapy and Pharmacology, 82(1), pp. 119-127. doi:10.1007/s00280-018-3596-6.
Imai H, et al. Efficacy and Safety of Cytotoxic Drug Chemotherapy After First-line EGFR-TKI Treatment in Elderly Patients With Non-small-cell Lung Cancer Harboring Sensitive EGFR Mutations. Cancer Chemother Pharmacol. 2018;82(1):119-127. PubMed PMID: 29737372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of cytotoxic drug chemotherapy after first-line EGFR-TKI treatment in elderly patients with non-small-cell lung cancer harboring sensitive EGFR mutations. AU - Imai,Hisao, AU - Minemura,Hiroyuki, AU - Sugiyama,Tomohide, AU - Yamada,Yutaka, AU - Kaira,Kyoichi, AU - Kanazawa,Kenya, AU - Kasai,Takashi, AU - Kaburagi,Takayuki, AU - Minato,Koichi, AU - ,, Y1 - 2018/05/08/ PY - 2017/12/28/received PY - 2018/05/01/accepted PY - 2018/5/9/pubmed PY - 2018/5/9/medline PY - 2018/5/9/entrez KW - Advanced non-small cell lung cancer KW - EGFR mutations KW - EGFR–TKIs KW - Elderly patients KW - Second-line cytotoxic drug chemotherapy SP - 119 EP - 127 JF - Cancer chemotherapy and pharmacology JO - Cancer Chemother. Pharmacol. VL - 82 IS - 1 N2 - PURPOSE: Epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) is effective as first-line chemotherapy for patients with advanced non-small-cell lung cancer (NSCLC) harboring sensitive EGFR mutations. However, whether the efficacy of second-line cytotoxic drug chemotherapy after first-line EGFR-TKI treatment is similar to that of first-line cytotoxic drug chemotherapy in elderly patients aged ≥ 75 years harboring sensitive EGFR mutations is unclear. Therefore, we aimed to investigate the efficacy and safety of cytotoxic drug chemotherapy after first-line EGFR-TKI treatment in elderly patients with NSCLC harboring sensitive EGFR mutations. METHODS: We retrospectively evaluated the clinical effects and safety profiles of second-line cytotoxic drug chemotherapy after first-line EGFR-TKI treatment in elderly patients with NSCLC harboring sensitive EGFR mutations (exon 19 deletion/exon 21 L858R mutation). Between April 2008 and December 2015, 78 elderly patients with advanced NSCLC harboring sensitive EGFR mutations received first-line EGFR-TKI at four Japanese institutions. Baseline characteristics, regimens, responses to first- and second-line treatments, whether or not patients received subsequent treatment, and if not, the reasons for non-administration were recorded. RESULTS: Overall, 20 patients with a median age of 79.5 years (range 75-85 years) were included in our analysis. The overall response, disease control, median progression-free survival, and overall survival rates were 15.0, 60.0%, 2.4, and 13.2 months, respectively. Common adverse events included leukopenia, neutropenia, anemia, thrombocytopenia, malaise, and anorexia. Major grade 3 or 4 toxicities included leukopenia (25.0%) and neutropenia (45.0%). No treatment-related deaths were noted. CONCLUSION: Second-line cytotoxic drug chemotherapy after first-line EGFR-TKI treatment among elderly patients with NSCLC harboring sensitive EGFR mutations was effective and safe and showed equivalent outcomes to first-line cytotoxic drug chemotherapy. SN - 1432-0843 UR - https://www.unboundmedicine.com/medline/citation/29737372/Efficacy_and_safety_of_cytotoxic_drug_chemotherapy_after_first_line_EGFR_TKI_treatment_in_elderly_patients_with_non_small_cell_lung_cancer_harboring_sensitive_EGFR_mutations_ L2 - https://dx.doi.org/10.1007/s00280-018-3596-6 DB - PRIME DP - Unbound Medicine ER -