Objective: To report the outcome of Chinese elderly patients with advanced non-small cell lung cancer (NSCLC) of treated with gefitinib at Peking Union Medical College Hospital.
Methods: From Oct. 2002 to Apr. 2006, 63 patients with advanced NSCLC received oral treatment with gefitinib (ZD1839) 250 mg/day. Median survival was calculated using the Kaplan-Meier method and a COX regression analysis was used to detect differences in median survival between strata.
Results: Adverse events (AEs) were generally mild (grade 1 and 2) and reversible. The most frequent AEs were rash 76.8% (43/56) and diarrhea 35.7% (20/56). The objective tumor response rate and stable disease rate were 25.4% and 55.6% respectively, and the median survival of all patients was 15.3 months (11.8 - 18.8 months). The rate of 1-year survival was 53%. The median survival was significantly related with ECOG scores, metastasis of liver, pleural effusion, disease progression after chemotherapy, and objective efficacy of gefitinib. Among 16 patients with no prior chemotherapy, the median survival was not significantly different as compared with that of other patients. Among the enrolled patients, 24 had disease progression and 23 had stable disease after prior chemotherapy, and their median survivals were statistically different. At the time of this analysis, 38 patients had disease progression, 15 of whom withdrew from taking gefitinib, and 23 continued gefitinib therapy until death. The median survivals for these subgroups were not significantly different. Objective responses were significantly related with rashes induced by gefitinib.
Conclusion: Our study suggests that treatment with gefitinib may be well tolerated and beneficial for Chinese elderly patients after failure of prior chemotherapy. Gefitinib could be administered as maintain therapy in patients after chemotherapy. Patients with disease progression should withdraw from taking gefitinib, and receive other systemic treatments.