Response assessment of gefitinib therapy in the epidermal growth factor receptor- mutant advanced adenocarcinoma lung at a tertiary care center in North India

Context: Oral tyrosine kinase inhibitors (TKIs) have been proven to improve response rates (RRs) and progression-free survival in a chemo-naïve setting in the epidermal growth factor receptor (EGFR)-mutant advanced lung adenocarcinoma patients in studies conducted in Western countries. Similar data from India are currently sparse. Aims: The aim is to study the epidemiological, clinical, and radiological profile of advanced-stage of lung adenocarcinoma patients harboring an EGFR mutation and to assess the response of TKIs in these patients. Settings and Design: This was a prospective observational study performed at a tertiary care hospital. Materials and Methods: A total of 40 advanced-stage lung adenocarcinoma patients who harbored an EGFR mutation and received an oral TKI (gefitinib) were included in the study and response was evaluated using the Response Evaluation Criteria for Solid Tumors. Statistical Analysis Used: Qualitative variables were compared using the Chi-square test/Fisher's exact test as appropriate. Results: A total of 30 (75%) patients had an exon 19 mutation and 3 (7.5%) patients had an exon 21 mutation. The overall RR to gefitinib was 57.5%. Eleven (27.5%) patients had partial response, 12 (30%) patients had stable disease (SD), and 6 (15%) patients had progressive disease. The RR was more favorable among females, rural residents, nonsmokers, patients having good performance score, and stage III disease. Conclusions: The overall RR to gefitinib was comparable to those reported in western studies but lower than those reported in Asian studies at our center.