Retreatment of lung adenocarcinoma patients with gefitinib who had experienced favorable results from their initial treatment with this selective epidermal growth factor receptor inhibitor: A report of three cases
Retreatment of lung adenocarcinoma patients with gefitinib who had experienced favorable results from their initial treatment with this selective epidermal growth factor receptor inhibitor: A report of three cases
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DOI：
10.3727/096504005775082020
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发表时间：
2005-01-01
影响因子：
3.1
通讯作者：
Sone, S
中科院分区：
文献类型：
--
作者：
Yano, S;Nakataki, E;Sone, S
吉非替尼是一种选择性表皮生长因子受体（EGFR）酪氨酸激酶抑制剂，对化疗难治性非小细胞肺癌（NSCLC）具有良好的抗肿瘤活性。然而，大多数应答者（对吉非替尼敏感的患者）在1.5年内复发，表明对吉非替尼的获得性耐药。在这里，我们报告三个化疗难治性NSCLC患者谁与吉非替尼复治。所有3例患者均为非吸烟者，组织学均为腺癌。虽然他们经历了成功的控制，从他们的初始治疗吉非替尼超过12个月，吉非替尼治疗终止，因为两个病例（例1和3）复发，在治疗过程中，例2发生肺泡出血。在停止初始吉非替尼治疗后超过7个月后，由于观察到进一步的肿瘤进展，他们再次接受吉非替尼治疗。在这3例病例中，病例I和2通过吉非替尼单药治疗超过7个月的复治控制良好，表明对复治敏感。例3也显示了几个肿瘤的大小消退，而其他一些病变进行性扩大，并在4个月后发展为恶性胸腔积液。这些观察结果表明，当1）初始治疗显示出良好的临床应答，2）初始吉非替尼治疗终止后有一段时间时，吉非替尼再治疗可能有用。
Gefitinib is a selective inhibitor of epidermal growth factor receptor (EGFR) tyrosine kinases, and shows favorable antitumor activity against chemorefractory non-small cell lung cancer (NSCLC). The majority of responders (patients who are sensitive to gefitinib), however, relapse within 1.5 years, indicating an acquired resistance to gefitinib. Here we report three chemotherapy refractory NSCLC patients who were retreated with gefitinib. All three cases were nonsmokers and showed an adenocarcinoma histology. While they had experienced successful control from their initial treatment with gefitinib for more than 12 months, gefitinib therapy was terminated because two cases (cases I and 3) relapsed during the therapy and case 2 suffered alveolar hemorrhage. After more than 7 months from the time of discontinuation of the initial gefitinib treatment, they were retreated with gefitinib, as further tumor progression was observed. Of the three cases, cases I and 2 were well controlled by retreatment with gefitinib monotherapy for more than 7 months, suggesting sensitivity to retreatment. Case 3 also showed a regression in size of several tumors, while some other lesions progressively enlarged and developed a malignant pleural effusion after 4 months. These observations suggest the possibility that retreatment with gefitinib might be useful when 1) initial treatment shows a favorable clinical response, and 2) there has been a period of time following the termination of the initial gefitinib treatment.