Subsequent chemotherapy improves survival outcome in advanced non-small-cell lung cancer with acquired tyrosine kinase inhibitor resistance

Chih Hsi Kuo, Shu Min Lin, Kang Yun Lee, Fu Tsai Chung, Meng Heng Hsieh, Yueh Fu Fang, Chih Ten Yu, Han Pin Kuo

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) provide promising effect against non-small-cell lung cancer (NSCLC), although most tumors acquire resistance. Our objective was to assess the survival outcome of patients with NSCLC with or without subsequent chemotherapy after acquired TKI resistance. Patients and Methods: A total of 114 patients with pathologically confirmed stage IIIB or IV NSCLC who had had disease control with TKIs were retrospectively reviewed. After acquired TKI resistance, patients received either best supportive care (BSC) only or BSC plus subsequent chemotherapy. Both groups were well balanced in regard to performance status, age, sex, histology subtype, and smoking status. Results: Sixty-seven patients (58.8%) received subsequent chemotherapy, and 47 patients (41.2%) received BSC only. The median overall survival (OS) and progression-free survival (PFS) from the time of TKI resistance in the subsequent-chemotherapy group (11.2 months and 3.5 months, respectively) were longer than those of the BSC group (3.8 months and 1.5 months, respectively; P <.01). Patients who subsequently received taxane-based chemotherapy exhibited higher a response rate and disease control rate (48.7% and 79.5%, respectively) than patients treated with a nontaxane regimen (21.4% and 53.5%, respectively; P <.05). Overall survival and PFS in patients after taxane-based subsequent chemotherapy (12.7 months and 5.1 months, respectively) were longer than those of patients given a nontaxane regimen (7 months and 1.8 months, respectively; P <.01). Conclusion: This study suggests that acquired TKI resistance should be managed aggressively. The higher antitumor response and survival outcome with a taxane-based regimen in this retrospective study could encourage further prospective investigation to confirm the efficacy of taxane over nontaxane chemotherapy in patients with NSCLC whose disease progresses with EGFR TKI treatment.

Original languageEnglish
Pages (from-to)51-56
Number of pages6
JournalClinical Lung Cancer
Volume11
Issue number1
DOIs
Publication statusPublished - 2010
Externally publishedYes

Fingerprint

Non-Small Cell Lung Carcinoma
Protein-Tyrosine Kinases
Drug Therapy
Survival
Epidermal Growth Factor Receptor
Disease-Free Survival
Histology
Retrospective Studies
Smoking
taxane

Keywords

  • Best supportive care
  • EGFR
  • Erlotinib
  • Gefitinib
  • T790M
  • Taxanes

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Pulmonary and Respiratory Medicine

Cite this

Subsequent chemotherapy improves survival outcome in advanced non-small-cell lung cancer with acquired tyrosine kinase inhibitor resistance. / Kuo, Chih Hsi; Lin, Shu Min; Lee, Kang Yun; Chung, Fu Tsai; Hsieh, Meng Heng; Fang, Yueh Fu; Yu, Chih Ten; Kuo, Han Pin.

In: Clinical Lung Cancer, Vol. 11, No. 1, 2010, p. 51-56.

Research output: Contribution to journalArticle

Kuo, Chih Hsi ; Lin, Shu Min ; Lee, Kang Yun ; Chung, Fu Tsai ; Hsieh, Meng Heng ; Fang, Yueh Fu ; Yu, Chih Ten ; Kuo, Han Pin. / Subsequent chemotherapy improves survival outcome in advanced non-small-cell lung cancer with acquired tyrosine kinase inhibitor resistance. In: Clinical Lung Cancer. 2010 ; Vol. 11, No. 1. pp. 51-56.
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abstract = "Background: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) provide promising effect against non-small-cell lung cancer (NSCLC), although most tumors acquire resistance. Our objective was to assess the survival outcome of patients with NSCLC with or without subsequent chemotherapy after acquired TKI resistance. Patients and Methods: A total of 114 patients with pathologically confirmed stage IIIB or IV NSCLC who had had disease control with TKIs were retrospectively reviewed. After acquired TKI resistance, patients received either best supportive care (BSC) only or BSC plus subsequent chemotherapy. Both groups were well balanced in regard to performance status, age, sex, histology subtype, and smoking status. Results: Sixty-seven patients (58.8{\%}) received subsequent chemotherapy, and 47 patients (41.2{\%}) received BSC only. The median overall survival (OS) and progression-free survival (PFS) from the time of TKI resistance in the subsequent-chemotherapy group (11.2 months and 3.5 months, respectively) were longer than those of the BSC group (3.8 months and 1.5 months, respectively; P <.01). Patients who subsequently received taxane-based chemotherapy exhibited higher a response rate and disease control rate (48.7{\%} and 79.5{\%}, respectively) than patients treated with a nontaxane regimen (21.4{\%} and 53.5{\%}, respectively; P <.05). Overall survival and PFS in patients after taxane-based subsequent chemotherapy (12.7 months and 5.1 months, respectively) were longer than those of patients given a nontaxane regimen (7 months and 1.8 months, respectively; P <.01). Conclusion: This study suggests that acquired TKI resistance should be managed aggressively. The higher antitumor response and survival outcome with a taxane-based regimen in this retrospective study could encourage further prospective investigation to confirm the efficacy of taxane over nontaxane chemotherapy in patients with NSCLC whose disease progresses with EGFR TKI treatment.",
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AU - Kuo, Chih Hsi

AU - Lin, Shu Min

AU - Lee, Kang Yun

AU - Chung, Fu Tsai

AU - Hsieh, Meng Heng

AU - Fang, Yueh Fu

AU - Yu, Chih Ten

AU - Kuo, Han Pin

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AB - Background: Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) provide promising effect against non-small-cell lung cancer (NSCLC), although most tumors acquire resistance. Our objective was to assess the survival outcome of patients with NSCLC with or without subsequent chemotherapy after acquired TKI resistance. Patients and Methods: A total of 114 patients with pathologically confirmed stage IIIB or IV NSCLC who had had disease control with TKIs were retrospectively reviewed. After acquired TKI resistance, patients received either best supportive care (BSC) only or BSC plus subsequent chemotherapy. Both groups were well balanced in regard to performance status, age, sex, histology subtype, and smoking status. Results: Sixty-seven patients (58.8%) received subsequent chemotherapy, and 47 patients (41.2%) received BSC only. The median overall survival (OS) and progression-free survival (PFS) from the time of TKI resistance in the subsequent-chemotherapy group (11.2 months and 3.5 months, respectively) were longer than those of the BSC group (3.8 months and 1.5 months, respectively; P <.01). Patients who subsequently received taxane-based chemotherapy exhibited higher a response rate and disease control rate (48.7% and 79.5%, respectively) than patients treated with a nontaxane regimen (21.4% and 53.5%, respectively; P <.05). Overall survival and PFS in patients after taxane-based subsequent chemotherapy (12.7 months and 5.1 months, respectively) were longer than those of patients given a nontaxane regimen (7 months and 1.8 months, respectively; P <.01). Conclusion: This study suggests that acquired TKI resistance should be managed aggressively. The higher antitumor response and survival outcome with a taxane-based regimen in this retrospective study could encourage further prospective investigation to confirm the efficacy of taxane over nontaxane chemotherapy in patients with NSCLC whose disease progresses with EGFR TKI treatment.

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