Correlation of EGFR (epidermal growth factor receptor) mutation status with Gefitinib response rate used as second-line therapy in patient with metastatic non-small-cell Lung Cancer

Correlation of EGFR (epidermal growth factor receptor) mutation status with Gefitinib response rate used as second-line therapy in patient with metastatic non-small-cell Lung Cancer. Sagar P.Kansara M.Pharm.,Dr Varsha J.Galani M.Pharm.,Ph.D.,Dr.Chirag J.Desai MD DM (Oncology)., Hemato-oncology clinic at Ahmrdabad; Vedanta institute of medical sciences at Ahmedabad;A.R.College of Pharmacy at Anand, Gujarat,India-380008.

Purpose: The aim of the study was to evaluate the efficacy of gefitinib and the epidermal growth factor receptor (EGFR) mutation to gefitinib response in a series of patients with pretreated advanced non-small-cell lung cancer (NSCLC).

Methods: A total of 20 patients who had failed at least one First line chemotherapy cycle received gefitinib 250 mg once daily. The mutation analysis of the EGFR kinase domain was performed for 20 patients using paraffin-embedded tumor tissue.

Results: The response rate was 30 % and the disease control rate was 75%. Objective response was correlated withAdenocarcinoma, female gender and non-smokers.The median PFS for patient with EGFR (+Ve) mutation was 8.08±2.67 months whereas it was5.25±0.707 months for patients without the mutation. PFS for patient with EGFR (+Ve) mutation was significant longer than patient with EGFR (-Ve) mutation. (P=0.0303).Active gene mutation was detected in 20 patients. Mutation rates were higherin Male patients than Femalepatients. There was no significant difference in smoking status, pathological features, responder and non-responder between patient with EGFR (+Ve) mutation and patient with EGFR (-Ve) mutation.

Conclusion: Gefitinib demonstrated significant antitumor activity with a less toxicity profile for pretreated patients with advanced NSCLC. Gefitinib prolonged progression free survival in patient with EGFR (+Ve) mutation as compared to patient with EGFR (-Ve) mutation. There is nosignificant relationship between EGFR mutation status and Gefitinib response rate in pretreated NSCLC patients.