Efficacy And Clinical/Molecular Predictors Of Erlotinib Monotherapy For Chinese Advanced Non-small Cell Lung Cancer

Purpose:Relationships between clinical factors and clinical outcomes were investigated in patients with advanced NSCLC.Methods:A retrospective analysis of clinical data was conducted in79patients who were given oral erlotinib at PUMC hospital from May2005to December2009.Results:79patients were enrolled in this study.50(63.3%) were male, and the mean age was60.9±12.0(range:35-83) years.30(38%) were at stage Ⅲ B,and49(62%) were at stage Ⅳ.19(24.1%) were with high differentiation tumor,49(62%) were with middle-low differentiation tumor. The majority of patients(88.6%) had adenocarcinoma.39(49.4%) were former or current smokers.55(69.6%) patients received erlotinib as second-or third-line therary. Skin rash happened on48(60.9%) patients.23patients had a PR,36patients had a SD,20patients had a PD, with a objective response rate of29.1%, and a disease control rate of74.7%. Female (p=0.023), non-smoking (p=0.013), patients with skin rash (p=0.047), high differentiation tumor (p=0.037) were significantly correlated with objective response ratel Lower ECOG PS (p=0.002), higher differentiation tumor (p=0.014), non-smoking (p=0.002), patients with skin rash (p<0.001) were significantly correlated with disease control rate. The median time to progression was35weeks (95%CI13-57weeks),6-months survival was81.8%,1-year survival was72.3%. High differentiation tumor (p=0.016), patients with skin rash (p<0.001) were significantly correlated with PFS. The most common adverse events were skin rash (60.9%) and diarrhea (26.6%).Conclusions:Erlotinib was safe and effective in treating Chinese patients with advanced NSCLC. PFS of patient who was with skin rash and high differentiation tumor was significantly longer. Purpose:Relationships between EGFR mRNA expression, EGFR gene mutations, KRAS gene mutations and clinical outcomes were investigated in patients with advanced NSCLC.Methods:17patients who could offer us qualified tumor samples were enrolled in this study. Tumor samples were accessed with mutant-enriched polymerase chain reaction assay (EGFR exon19/20/21、KRAS exon2/3mutations) and branched-DNA polymerase chain reaction assay (EGFR mRNA expression).Results:PFS of patients with EGFR exons19/21mutations was66weeks, significantly longer than patients with wild type EGFR exons19/21(p=0.018).No significant relationships were found between EGFR mRNA expression, EGFR exons19/21mutations, KRAS mutation with ORR or DCR. No significant relationships were found between EGFR mRNA expression, KRAS mutation with PFS. Relationships between EGFR mRNA expression, EGFR gene mutations, KRAS gene mutations and OS is still being observed.Conclusions:PFS of advanced NSCLC patients with EGFR exons19/21mutations was significantly longer.