Erlotinib versus gefitinib for brain metastases in Asian patients with exon 19 EGFR-mutant lung adenocarcinoma: a retrospective, multicenter study

BMC Pulm Med. 2018 Nov 20;18(1):171. doi: 10.1186/s12890-018-0734-1.

Abstract

Background: The purpose of this study was to compare clinical outcomes of Erlotinib versus Gefitinib in the treatment of Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and newly diagnosed brain metastases.

Methods: Consecutive Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and newly diagnosed brain metastases were identified and initially received peroral administration of 150 mg/d erlotinib or 250 mg/d gefitinib during 2009-2015. Overall survival (OS) was the primary endpoint. Progression-free survival (PFS) was the second endpoint.

Results: The cohort consisted of 227 Asian patients (erlotinib-treated cohort: n = 112, mean age = 58.5 years [SD: 20.13]; gefitinib-treated cohort: n = 115, mean age = 58.4 years [SD: 19.52]). In a multivariate analysis controlling for age, sex and time span of smoking history, significant difference was detected in the 36-month OS between erlotinib and gefitinib groups (58.3% vs. 49.1%, p = 0.012). There was also significant difference in the 36-month PFS between erlotinib and gefitinib groups (64% vs. 53%, p = 0.013).

Conclusion: For Asian patients with exon 19 EGFR-mutant lung adenocarcinoma and brain metastases, erlotinib was associated with a significantly longer OS and a more prolonged PFS and compared with gefitinib.

Keywords: Erlotinib; Gefitinib; Lung adenocarcinoma; Overall survival.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adenocarcinoma of Lung / drug therapy*
  • Adenocarcinoma of Lung / genetics
  • Adenocarcinoma of Lung / mortality
  • Adenocarcinoma of Lung / pathology
  • Adult
  • Aged
  • Asian People / genetics
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / secondary
  • China / epidemiology
  • ErbB Receptors / genetics
  • Erlotinib Hydrochloride / therapeutic use*
  • Exons
  • Female
  • Gefitinib / therapeutic use*
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / genetics
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Mutation
  • Protein Kinase Inhibitors / therapeutic use
  • Retrospective Studies
  • Survival Analysis

Substances

  • Protein Kinase Inhibitors
  • Erlotinib Hydrochloride
  • EGFR protein, human
  • ErbB Receptors
  • Gefitinib