Gefitinib as first-line treatment for patients with epidermal growth factor receptor-mutated advanced lung adenocarcinoma: a single institution experience in Taiwan.

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) represent a new treatment option for patients with advanced lung adenocarcinoma. In this article we assessed the treatment response and tried to identify prognostic factors which may provide some information different from previously published reports in groups with better performance status (PS) than our enrolled patients. The records of 85 patients with EGFR-mutated advanced lung adenocarcinoma who received gefitinib 250 mg once daily as front-line monotherapy between October 2007 and October 2012 were analysed. Direct sequencing methods were used for detecting EGFR mutations. SPSS (version 20) software was used for all data analysis. The median overall survival (OS) and progression free survival (PFS) were 25.6 and 6.9 months, respectively. No statistical significance between the two groups of exon 19 and exon 21 in OS and PFS was registered (p=0.414 and p=0.519, respectively). The group of patients treated > 3 months had a better median OS survival compared with those treated < 3 months (25.6 vs 4.9 months, p<0.001). In multivariate analysis, significant benefit on OS was observed in patients with ECOG PS scores of 0-2 (p=0.002) and those treated for longer time periods (p<0.001), rather than age, sex and smoking. Among the adverse effects (AEs), skin manifestation was correlated with significantly better OS (p=0.007) but insignificant effect on PFS (p=0.131). Good ECOG PS, longer TKI use and skin rash were significant factors predictive for gefitinib antitumor activity.