Erlotinib as salvage treatment after failure to first-line gefitinib in non-small cell lung cancer

Abstract

BACKGROUND: Chemotherapy is the mainstay treatment for advanced non-small cell lung cancer (NSCLC). Gefitinib, an epidermal growth factor receptor - tyrosine kinase inhibitor (EGFR-TKI), has been recently shown to be effective as a first-line treatment in Asian patients with advanced NSCLC, especially for those with favourable clinical features such as female, non-smoker and adenocarcinoma. However, resistance to gefitinib ensues invariably and there is little evidence as for the effectiveness of subsequent salvage treatment. PURPOSE: To evaluate the efficacy of erlotinib, another EGFR-TKI, after failed first-line use of gefitinib. METHOD: Retrospective review of NSCLC patients with favourable clinical features who received gefitinib as first-line treatment and subsequent salvage treatment with erlotinib. RESULTS: A total of 21 patients with NSCLC were included in the study. Among them, 18 (85.7%) patients had disease control with gefitinib and 11 (52.4%) patients with erlotinib. There was an association between the disease control with gefitinib and erlotinib (p=0.016). The disease control rate of erlotinib was independent of the chemotherapy use between the two EGFR-TKIs. CONCLUSION: For NSCLC patients with favourable clinical features, erlotinib was effective in those who had prior disease control with first-line gefitinib.