Is the importance of achieving stable disease different between epidermal growth factor receptor tyrosine kinase inhibitors and cytotoxic agents in the second-line setting for advanced non-small cell lung cancer?

Takayasu Kurata, Keitaro Matsuo, Minoru Takada, Masaaki Kawahara, Masahiro Tsuji, Yuka Matsubara, Nagahiro Otani, Shigeki Matsuyama, Kenya Muraishi, Tetsuya Fujita, Masato Ishikawa, Keita Koyano, Isamu Okamoto, Taroh Satoh, Kenji Tamura, Kazuhiko Nakagawa, Masahiro Fukuoka

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19 Citations (Scopus)

Abstract

BACKGROUND: It is controversial whether achieving stable disease leads to a survival benefit and whether the importance of achieving stable disease differs between cytotoxic agents and molecular targeted agents. To examine these questions, the authors retrospectively reviewed phase II and III studies in the second-line setting for advanced non-small cell lung cancer using epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) and cytotoxic agents separately. METHODS: The authors chose 45 trials for the chemotherapy group and nine for the EGFR TKI group by searching the PubMed database. All nine trials in the EGFR TKI group concern gefitinib and erlotinib. RESULTS: The median survival time increased 0.0375 month with each 1% increase in stable disease rate (p = 0.039), and each 1% increase in response rate resulted in 0.0744 (p < 0.001) month of median survival time in the analysis combined with both cytotoxic agents and EGFR TKIs. Main and interaction terms for EGFR TKI treatment were not statistically significant. With respect to time to progression, only response rate showed a statistically significant relationship with survival. CONCLUSIONS: To obtain response seems to be more important than to achieve stable disease for both cytotoxic agents and EGFR TKIs, although achieving stable disease is still valuable. The relationship between survival and response or stable disease appears similar for cytotoxic agents and EGFR TKIs.

Original languageEnglish
Pages (from-to)684-691
Number of pages8
JournalJournal of Thoracic Oncology
Volume1
Issue number7
DOIs
Publication statusPublished - Sep 2006
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pulmonary and Respiratory Medicine

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    Kurata, T., Matsuo, K., Takada, M., Kawahara, M., Tsuji, M., Matsubara, Y., Otani, N., Matsuyama, S., Muraishi, K., Fujita, T., Ishikawa, M., Koyano, K., Okamoto, I., Satoh, T., Tamura, K., Nakagawa, K., & Fukuoka, M. (2006). Is the importance of achieving stable disease different between epidermal growth factor receptor tyrosine kinase inhibitors and cytotoxic agents in the second-line setting for advanced non-small cell lung cancer? Journal of Thoracic Oncology, 1(7), 684-691. https://doi.org/10.1097/01243894-200609000-00014