| Title: | Randomized phase II study of concurrent versus sequential alternating gefitinib and chemotherapy in previously untreated non-small cell lung cancer with sensitive EGFR mutations : NEJ005/TCOG0902 |
| Authors: | Sugawara, S. Browse this author |
| Oizumi, Satoshi Browse this author →KAKEN DB |
| Minato, K. Browse this author |
| Harada, T. Browse this author |
| Inoue, A. Browse this author |
| Fujita, Y. Browse this author |
| Maemondo, M. Browse this author |
| Yoshizawa, H. Browse this author |
| Ito, K. Browse this author |
| Gemma, A. Browse this author |
| Nishitsuji, M. Browse this author |
| Harada, M. Browse this author |
| Isobe, H. Browse this author |
| Kinoshita, I. Browse this author |
| Morita, S. Browse this author |
| Kobayashi, K. Browse this author |
| Hagiwara, K. Browse this author |
| Kurihara, M. Browse this author |
| Nukiwa, T. Browse this author |
| Keywords: | non-small cell lung cancer |
| first-line |
| EGFR-TKI |
| chemotherapy |
| combination |
| EGFR mutation |
| Issue Date: | May-2015 |
| Publisher: | Oxford University Press |
| Journal Title: | Annals of oncology |
| Volume: | 26 |
| Issue: | 5 |
| Start Page: | 888 |
| End Page: | 894 |
| Publisher DOI: | 10.1093/annonc/mdv063 |
| PMID: | 25669832 |
| Abstract: | Background: The first-line combination of an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) and platinum-based doublet chemotherapy has not been sufficiently evaluated for patients with EGFR-mutant non-small cell lung cancer (NSCLC). This randomized phase II study was designed to select a combination regimen for phase III evaluation. Patients and methods: Chemotherapy-naive patients with advanced non-squamous, EGFR-mutant NSCLC were randomly assigned to receive either a concurrent or a sequential alternating regimen with gefitinib (250 mg) and carboplatin/pemetrexed [area under the curve (AUC) = 6 and 500 mg/m(2); 3-weekly]. The primary end point was progression-free survival (PFS). Secondary end points were overall survival (OS), response, and safety. Results: All 80 patients enrolled were eligible and assessable for efficacy (41 and 39 patients in the concurrent and sequential alternating regimen groups, respectively). Median PFS was 18.3 months for the concurrent regimen and 15.3 months for the sequential alternating regimen [hazard ratio (HR) 0.71 (0.42-1.20), P = 0.20]. Although OS data are immature (16 and 24 death events), median survival times were 41.9 and 30.7 months in the concurrent and sequential alternating regimen groups, respectively [HR 0.51 (0.26-0.99); P = 0.042]. Response rates were similar in both groups (87.8% and 84.6%). Hematological and non-hematological adverse events were common and reversible; interstitial lung disease was neither frequent nor fatal (two cases in each group; 5% of all patients). Conclusion: This is the first randomized study to investigate the efficacy of combinational EGFR-TKI and chemotherapy in the EGFR-mutated setting. Both regimens had promising efficacy with predictable toxicities, although concurrent regimens might provide better OS. The concurrent regimen was chosen to compare with gefitinib monotherapy in our ongoing phase III study. |
| Rights: | This is a pre-copy-editing, author-produced PDF of an article accepted for publication in "Annals of Oncology" following peer review. The definitive publisher-authenticated version [Ann Oncol (2015) 26 (5): 888-894] is available online at: http://doi.org/10.1093/annonc/mdv063 |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/60656 |
| Appears in Collections: | 医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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