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Long-term survival in three patients with metastatic non-small cell lung cancer treated with gefitinib
Katsumi Nakatomi1, Hiroshi Soda, Takeshi Kitazaki
1Internal Medicine, Nagasaki Prefectural Shimabara Hospital, Shimabara 855-0861, Japan.
Abstract:
Gefitinib, a tyrosine kinase inhibitor of epidermal growth factor receptor (EGFR), produces radiographic regression and symptom relief in patients with refractory advanced non-small cell lung cancer. However, it remains controversial whether gefitinib improves patient survival. We report three cases of refractory metastatic non-small cell lung cancer who have survived approximately 3 years since they first started gefitinib. These long-term survivors were Japanese female non-smokers with adenocarcinoma, who often had multiple lung metastases and were effectively re-treated with gefitinib. One patient had a surgical specimen available for DNA extraction and showed deletions in exon 19 of EGFR. Our experience suggests that gefitinib may improve long-term survival in selected patients. Further studies are required to identify biomarkers downstream of the EGFR mutations that are involved in multiple lung metastases and which could identify those patients who may benefit from gefitinib re-treatment.
Insights
Gefitinib (epidermal growth factor receptor tyrosine kinase inhibitor) may improve survival in select non-small cell lung cancer patients. Three refractory cases survived 3 years, suggesting potential long-term benefits in specific patient groups.
Area of Science:
- Oncology
- Medical Genetics
Background:
- Gefitinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, offers radiographic regression and symptom relief in advanced non-small cell lung cancer (NSCLC).
- The impact of gefitinib on patient survival in refractory NSCLC remains controversial.
Observation:
- This report details three cases of refractory metastatic NSCLC who experienced prolonged survival of approximately three years after initiating gefitinib treatment.
- These long-term survivors were characterized as Japanese, female, non-smokers with adenocarcinoma, often presenting with multiple lung metastases.
- One patient's tumor specimen revealed EGFR exon 19 deletions.
Findings:
- The observed long-term survival in these selected NSCLC patients suggests gefitinib may enhance survival outcomes.
- Effective re-treatment with gefitinib was noted in patients with multiple lung metastases.
Implications:
- Gefitinib could offer significant long-term survival benefits for a subset of advanced NSCLC patients.
- Further research is needed to identify predictive biomarkers for gefitinib response and re-treatment efficacy, particularly concerning EGFR mutations and multiple lung metastases.
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