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首页> 外文期刊>Thoracic cancer. >Salvage treatment with erlotinib after gefitinib failure in advanced non‐small‐cell lung cancer patients with poor performance status: A matched‐pair case–control study
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Salvage treatment with erlotinib after gefitinib failure in advanced non‐small‐cell lung cancer patients with poor performance status: A matched‐pair case–control study

机译：吉非替尼治疗失败的晚期非小细胞肺癌患者，吉非替尼治疗失败后进行厄洛替尼的挽救治疗：配对病例对照研究

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AbstractPurpose:  Gefitinib plays an important role in non-small-cell lung cancer (NSCLC) treatment; however, progression of the disease occurs in most patients even after an initial response. The role of erlotinib after gefitinib failure has been investigated but continues to be debated, especially in heavily treated patients with poor performance status (PS). Therefore, a retrospective matched-pair case–control study was carried out to evaluate the role of erlotinib after gefitinib failure in advanced NSCLC patients.Methods:  A total of 58 patients were identified. The two groups were balanced with demographic and baseline clinical characteristics. All patients had PS ≥2 and most of them (89.7%) had received more than two systemic therapies before erlotinib or best supportive care (BSC). The epidermal growth factor receptor (EGFR) and KRAS genotypes were analyzed in 36 (62.1%) patients, 19 of them were in the erlotinib group.Results:  Median overall survival (OS) for all patients was 6 months. Median OS for patients who received erlotinib and BSC was 10 and 3 months, respectively (P= 0.001). Disease control rate (DCR) and objective response rate (ORR) were 51.7% and 10.3% in patients receiving erlotinib, respectively, while median time to progression (TTP) was 3 months. Among the 19 patients in the erlotinib group with biomarker results available, those with EGFR mutation achieved longer median TTP (P= 0.016) and better DCR (P= 0.177) than those with wild-type EGFR.Conclusions:  A switch to erlotinib after gefitinib failure may represent a better therapeutic option for advanced NSCLC patients with poor PS, and an EGFR mutation seemed to be associated with better survival rate.
机译：摘要目的：吉非替尼在非小细胞肺癌（NSCLC）治疗中起重要作用;然而，即使在最初反应后，大多数患者仍会发生疾病进展。厄洛替尼在吉非替尼治疗失败后的作用已被研究，但仍在争论中，特别是在表现不佳（PS）的经过严格治疗的患者中。因此，进行了一项回顾性配对病例对照研究，以评估吉非替尼治疗失败后厄洛替尼在晚期NSCLC患者中的作用。方法：identified确定了58例患者。两组在人口统计学和基线临床特征上保持平衡。所有患者的PS≥2，其中大多数（89.7％）在接受厄洛替尼或最佳支持治疗（BSC）之前接受了两种以上的系统治疗。对36例（62.1％）患者进行了表皮生长因子受体（EGFR）和KRAS基因型分析，其中19例属于厄洛替尼组。结果：所有患者的中位总生存期（OS）为6个月。接受厄洛替尼和BSC的患者的中位OS分别为10个月和3个月（P = 0.001）。接受厄洛替尼治疗的患者的疾病控制率（DCR）和客观缓解率（ORR）分别为51.7％和10.3％，而平均进展时间（TTP）为3个月。在具有生物标志物结果的埃罗替尼组的19例患者中，EGFR突变的患者比野生型EGFR的患者具有更高的中位TTP（P = 0.016）和更好的DCR（P = 0.177）。结论：吉非替尼治疗后转用厄洛替尼失败可能是PS较差的晚期NSCLC患者更好的治疗选择，EGFR突变似乎与更好的生存率相关。

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