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First-line gefitinib therapy for elderly patients with non-small cell lung cancer harboring EGFR mutation: Central Japan Lung Study Group 0901

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Abstract

Background

The population of elderly patients with lung cancer is increasing worldwide. Although first-line gefitinib is one of the standard treatments for advanced non-small cell lung cancer (NSCLC) harboring epidermal growth factor receptor (EGFR) mutation, few data have been reported regarding gefitinib and elderly patients.

Patients and methods

Chemotherapy-naïve patients aged 70 years or older with stage IIIB or IV NSCLC harboring EGFR-activating mutation were enrolled and treated with 250 mg of gefitinib daily until disease progression. The primary end point was response rate, and secondary end points were survival, safety, and quality of life.

Results

Twenty patients were enrolled, and the median age was 79.5 years (range 72–90). Overall response rate was 70 % (95 % CI 45.7–88.1 %), and the disease control rate was 90 % (95 % CI 68.3–98.7 %). The median progression-free survival and overall survival time were 10.0 and 26.4 months, respectively. The Functional Assessment of Cancer Therapy-Lung Cancer Subscale (FACT-LCS) scores improved significantly 4 weeks after the initiation of gefitinib (P = 0.037) and maintained favorably over a 12-week assessment period. Among the seven items of FACT-LCS, shortness of breath and cough improved significantly after 4 weeks of treatment (P = 0.046 and P = 0.008, respectively). The most common adverse events were rash and liver dysfunction. Although Grade 1 pneumonitis developed in one patient, no treatment-related death was observed.

Conclusion

First-line gefitinib therapy is effective and feasible for elderly patients harboring EGFR mutation, and improves disease-related symptoms, especially pulmonary symptoms like shortness of breath and cough.

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Conflict of interest

Kosuke Takahashi, Hiroshi Saito, Yoshinori Hasegawa, Yasuteru Sugino, and Joe Shindoh received honoraria from AstraZeneca. Yoshinori Hasegawa received research funding for his institute from AstraZeneca.

Author information

Authors and Affiliations

  1. Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, 18 Kuriyado Kake-machi, Okazaki, Aichi, 444-0011, Japan

    Kosuke Takahashi & Hiroshi Saito

  2. Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Yoshinori Hasegawa

  3. Center for Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan

    Masahiko Ando

  4. Department of Respiratory Medicine, Nagoya Ekisaikai Hospital, Nagoya, Japan

    Masashi Yamamoto

  5. Department of Respiratory Medicine, Komaki Municipal Hospital, Komaki, Japan

    Eiji Kojima

  6. Department of Respiratory Medicine, Toyota Memorial Hospital, Toyota, Japan

    Yasuteru Sugino

  7. Department of Respiratory Medicine and Allergy, Tosei General Hospital, Seto, Japan

    Tomoki Kimura

  8. Department of Respiratory Medicine, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan

    Fumio Nomura

  9. Department of Respiratory Medicine, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan

    Tomohiko Ogasawara

  10. Department of Respiratory Medicine, Ogaki Municipal Hospital, Ogaki, Japan

    Joe Shindoh

  11. Department of Respiratory Medicine, Kariya Toyota General Hospital, Kariya, Japan

    Norio Yoshida

  12. Department of Respiratory Medicine, Toyohashi Municipal Hospital, Toyohashi, Japan

    Ryujiro Suzuki

Authors
  1. Kosuke Takahashi
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  2. Hiroshi Saito
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  3. Yoshinori Hasegawa
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  4. Masahiko Ando
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  5. Masashi Yamamoto
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  6. Eiji Kojima
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  7. Yasuteru Sugino
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  8. Tomoki Kimura
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  9. Fumio Nomura
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  10. Tomohiko Ogasawara
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  11. Joe Shindoh
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  12. Norio Yoshida
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  13. Ryujiro Suzuki
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Corresponding author

Correspondence to Kosuke Takahashi.

Additional information

This trial is registered at UMIN-CTR, Number UMIN000001863.

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Takahashi, K., Saito, H., Hasegawa, Y. et al. First-line gefitinib therapy for elderly patients with non-small cell lung cancer harboring EGFR mutation: Central Japan Lung Study Group 0901. Cancer Chemother Pharmacol 74, 721–727 (2014). https://doi.org/10.1007/s00280-014-2548-z

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  • DOI: https://doi.org/10.1007/s00280-014-2548-z

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