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전남대학교 의과대학
Abstract
Kyu-Sik Kim1,2, Ju-Yeon Jeong1,2, Young-Chul Kim1,2, Kook-Joo Na1,3, Yun-Hyeon Kim1,4, Sung-Ja Ahn1,5, Sun-Mi Baek1, Chang-Soo Park6, Chang-Min Park2, Yu-Il Kim2, Sung-Chul Lim2 and Kyung-Ok Park7
1Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, Jeollanam-do, South Korea; Departments of 2Pulmonology and Critical Care Medicine, 3Thoracic and Cardiovascular Surgery, 4Diagnostic Radiology, 5Radiation Oncology, and 6Pathology, Chonnam National University Medical School, Gwangju, South Korea; and 7Department of Internal Medicine, Seonam University Medical School, Jeonbuk, South Korea
Requests for reprints:
Young-Chul Kim, Lung and Esophageal Cancer Clinic, Chonnam National University Hwasun Hospital, 160 Ilsim-ri, Hwasun, Jeollanam-do, 519-809 South Korea. Phone: 82-61-379-7614; Fax: 82-61-379-7010
Abstract
Gefitinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, has a response rate of 10% to 20% in refractory non?small cell lung carcinoma. Although female gender, adenocarcinoma, and never having smoked are possible markers of a favorable response, mutations of the EGFR gene have also been reported to be highly significant predictors of response. Seventy patients with relapsed non?small cell lung carcinoma were enrolled in the Expanded Access Program. After the drug became available commercially, 28 more patients were treated with gefitinib. Response evaluations were feasible in 80 patients. Twenty-seven tumor specimens (8 responders and 19 nonresponders) were available for the sequence analysis of the EGFR gene. The response rate was 25% (20/80) and the disease control rate (remission + stable disease) was 47.5% (38/80). The response rate was significantly higher for adenocarcinoma (41.0%) versus non-adenocarcinoma (9.8%, P = 0.001), in those who never smoked (58.8%) versus smokers (15.9%, P < 0.001), and in females (42.1%) versus males (19.7%, P = 0.049). A deletion or mutation of the EGFR gene was found in six of eight responders. Remission was noted in all patients with a mutation, whereas the response rate was 9.5% (2/21) in patients without a mutation (P < 0.001). The predictors of response showed significant correlations with survival and time to progression. In a multivariate logistic analysis, the independent predictors of response were smoking history and adenocarcinoma. Given that 9.5% of smokers and 6.7% of those with non-adenocarcinoma showed a mutation of the EGFR gene, the genetic profile may replace those variables as an independent predictor of a response.
Receptor, Epidermal Growth Factor, Mutation, Carcinoma, Non Small Cell Lung, Gefitinib, Prediction of response
Footnotes
The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact.
논문정보
- Research article
- 2005년 03월 (BRIC 등록일 )
- 국내 연구진
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