Tuberc Respir Dis.  2009 Apr;66(4):280-287.

Comparison of Gefitinib and Erlotinib for Patients with Advanced Non-Small-Cell Lung Cancer

• Lee JH
• Lee KE
• Ryu YJ
• Chun EM
• Chang JH

Abstract

BACKGROUND
The epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs), became an attractive therapeutic option for advanced non-small-cell lung cancer (NSCLC). Several studies suggested that there might be some different efficacy or response predictors between gefitinib and erlotinib. We compared the efficacy and toxicity of gefitinib and erlotinib in Korean patients with advanced NSCLC and evaluated specific predictors of response for both gefitinib and erlotinib.
METHODS
We collected the clinical information on patients with advanced NSCLC, who were treated with gefitinib or erlotinib at the Ewha Womans University Hospital, between July 2003 and February 2009. Median survival times were calculated using the Kaplan-Meier method.
RESULTS
Eighty-six patients (52 gefitinib vs. 34 erlotinib) were enrolled. Patient median age was 64 years; 53 (62%) subjects were male. Out of the 86 patients treated, 83 received response evaluation. Of the 83 patients, 35 achieved a response and 12 experienced stable disease while 36 experienced progressive disease, resulting in a response rate of 42% and a disease control rate of 57%. After a median follow-up of 502 days, the median progression-free and overall survival time was 129 and 259 days, respectively. Comparing patients by treatment (gefitinib vs erlotinib), there were no significant differences in the overall response rate (44% vs. 39%, p=0.678), median survival time (301 days vs. 202 days, p=0.151), or time to progression (136 days vs. 92 days, p=0.672). Both EGFR-TKIs showed similar toxicity. In a multivariate analysis using Cox regression model, adenocarcinoma was an independent predictor of survival (p=0.006; hazard ratio [HR], 0.487; 95% confidence interval [CI], 0.292-0.811). Analyses of subgroups did not show any difference in response predictors between gefitinib and erlotinib.
CONCLUSION
Comparing gefitinib to erlotinib, there were no differences in the response rate, overall survival, progression-free survival, or toxicity. No specific predictor of response to each EGFR-TKI was identified.

Keyword

Non-small-cell lung carcinoma; Epidermal growth factor receptor; Tyrosine kinase inhibitors; Efficacy

MeSH Terms

Adenocarcinoma
Carcinoma, Non-Small-Cell Lung
Disease-Free Survival
Female
Follow-Up Studies
Humans
Lung
Lung Neoplasms
Male
Multivariate Analysis
Protein-Tyrosine Kinases
Quinazolines
Receptor, Epidermal Growth Factor
Erlotinib Hydrochloride
Protein-Tyrosine Kinases
Quinazolines
Receptor, Epidermal Growth Factor

Figure

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  Figure 1 Survival outcomes based on gefitinib and erlotinib received. Tick marks indicate censored data: (A) overall survival and (B) progression-free survival.

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  Figure 2 Survival outcomes based on adenocarcinoma and non-adenocarcinoma.

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