Objective: To compare the efficacy of gefitinib monotherapy across different age groups of patients with advanced lung adenocarcinoma.
Methods: Clinical data of patients (mostly Chinese) with advanced lung adenocarcinoma who were non-smokers or light smokers and had received oral gefitinib (250mg/d) between October 2006 and December 2009 were reviewed retrospectively. The 93 enrolled patients (25 male and 68 female; median age, 62.5 years), were divided into three age groups: < or = 49 years (n = 22), 50-69 years (n = 53), and > or = 70 years (n = 18). Among them, 84 patients had received at least one chemotherapy regimen previously. The objective response rate (ORR), time to disease progression (TTP), median overall survival (MOS) and adverse effects in response to gefitinib treatment were analyzed in the above age groups.
Results: Out of 93 patients, a complete response was seen in 5 patients, partial response in 43 patients, stable disease in 36 patients, and disease progression in 9 patients. ORR was 51.6%, and the disease control rate (DCR) was 90.3%. No significant correlation was observed between ORR of gefitinib treatment and the baseline clinical characteristics of the patients. The median TTP was 12.6 months, and median overall survival (MOS) was 23.4 months. Gefitinib treatment-related UP was prolonged with increasing age: 8.2 months, 14.2 months and 18.2 months in the age groups of < or = 49-years, 50-69-years and > or = 70-years, respectively (log-rank P = 0.002). MOS in the three age groups was 20.4 months, 23.6 months and 22.0 months, respectively (P > 0.05). The most common adverse effects were rash and diarrhoea, and rash seemed to be correlated with ORR (ORR = 2.631; p = 0.044, 95% CI: 1.025-6.753).
Conclusions: In Asian patients with advanced lung adenocarcinoma who were non-smokers or light smokers and were treated with gefitinib, progression-free survival was correlated with age. Elderly patients (> or = 70 years) seemed more likely to benefit from gefitinib treatment.