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Comparative Study
. 2024 Nov;62(6):1137-1141.
doi: 10.1016/j.resinv.2024.09.010. Epub 2024 Oct 3.

Comparison of efficacy of gefitinib and osimertinib for untreated EGFR mutation-positive non-small-cell lung cancer in patients with poor performance status

Kazuhisa Nakashima  1 , Hiroaki Kodama  2 , Haruyasu Murakami  2 , Toshiaki Takahashi  2 , Keita Kawakado  3 , Takashi Yanagawa  3 , Kashu Kitani  4 , Takamasa Hottta  4 , Masaaki Abe  5 , Kosuke Hamai  5 , Takuya Tanimoto  6 , Nobuhisa Ishikawa  6 , Tomoki Tamura  7 , Shoichi Kuyama  7 , Takeshi Isobe  1 , Yukari Tsubata  8
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Free article
Comparative Study

Comparison of efficacy of gefitinib and osimertinib for untreated EGFR mutation-positive non-small-cell lung cancer in patients with poor performance status

Kazuhisa Nakashima et al. Respir Investig. 2024 Nov.
Free article

Abstract

Background: There is a dearth of studies on the efficacy and safety of the tyrosine kinase inhibitors osimertinib (OSI) and gefitinib (GEF) in treating epidermal growth factor receptor (EGFR) mutation-positive non-small cell lung cancer (NSCLC), even in patients with poor performance status (PS).

Methods: We retrospectively reviewed and compared data of 113 patients with EGFR mutation-positive NSCLC with Eastern Cooperative Oncology Group PS 2-4 who were administered OSI 80 mg/day or GEF 250 mg/day from May 2016 to March 2022.

Results: The GEF group (39 patients; median age: 74 years) included 20 patients with a PS of 2, 17 with a PS of 3, and 2 with a PS of 4. The OSI group (74 patients; median age: 76 years) included 48 patients with a PS of 2, 24 with a PS of 3, and 2 with a PS of 4. The overall response rates were 69% and 66% in the GEF and OSI groups, respectively. The disease control and PS improvement rates were 89% and 51% in both groups, respectively. The median progression-free survival in the GEF and OSI groups was 6.9 and 9.2 months, respectively (p = 0.15). The OSI group experienced better overall survival than the GEF group (median: 20.9 vs. 13.0 months, p = 0.0031). The incidence of pneumonitis was 10% and 11% in the GEF and OSI groups, respectively. One treatment-related death owing to pneumonitis occurred in the GEF group.

Conclusions: OSI may be a useful treatment for untreated EGFR mutation-positive NSCLC with poor PS.

Keywords: EGFR mutation; Gefitinib; Non-small-cell lung cancer; Osimertinib; Poor performance status.

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Conflict of interest statement

Declaration of competing interest Kazuhisa Nakashima has received personal fees from Taiho Pharmaceutical, Chugai Pharma, AstraZeneca, Eli Lilly Japan, Nippon Kayaku, and Bristol-Myers Squibb. Hiroaki Kodama has received personal fees from Chugai Pharma and Novartis Pharma. Haruyasu Murakami has received personal fees from Chugai Pharma, Daiichi Sankyo, AstraZeneca, Takeda, Amgen, Ono Pharmaceutical, Bristol-Myers Squibb, MSD, Pfizer, Novartis, Eli Lilly Japan, Taiho Pharmaceutical, Eisai, and Nippon Kayaku, grants from Chugai Pharma, AstraZeneca, Abbvie, Daiichi Sankyo, IQvia, Taiho Pharmaceutical and Bayer. Toshiaki Takahashi has received personal fees from AstraZeneca and MSD, and grants from Chugai Pharma, MSD, Eli Lilly Japan, Merck Biopharma Japan, AnHeart Therapeutics Inc., and Amgen. Kosuke Hamai has received personal fees from Boehringer Ingelheim, Eli Lilly Japan, AstraZeneca, Ono Pharmaceutical, Chugai Pharma, Merck & Co., and Taiho Pharmaceutical. Nobuhisa Ishikawa has received personal fees from AstraZeneca, Boehringer Ingelheim, Novartis, Ono Pharmaceutical, Eli Lilly Japan, Chugai Pharma, Taiho Pharmaceutical, MSD, Takeda, and Pfizer. Shoichi Kuyama has received personal fees from Chugai Pharma, Boehringer Ingelheim, Pfizer, MSD, Kyowa Kirin, Daiichi Sankyo, Novartis, Bristol-Myers Squibb, Eli Lilly Japan, AstraZeneca, Taiho Pharmaceutical, Hisamitsu Pharmaceutical, and Nippon Kayaku. Takeshi Isobe has received personal fees from MSD, AstraZeneca, Ono Pharmaceutical, Daiichi Sankyo, Amgen, Taiho Pharmaceutical, Takeda. Chugai Pharma, Nippon Kayaku, Eli Lilly Japan, Boehringer Ingelheim, Pfizer, and Bristol-Myers Squibb Japan, and grants from Daiichi Sankyo, Novartis, Chugai Pharma, Ono Pharmaceutical, Taiho Pharmaceutical, and Boehringer Ingelheim. Yukari Tsubata has received personal fees from MSD, AstraZeneca, Amgen, Daiichi Sankyo, Taiho Pharmaceutical, Takeda, Chugai Pharma, Eli Lilly Japan, Nippon Kayaku, Novartis, Pfizer, and Bristol-Myers Squibb, and grants from Pfizer and Ono Pharmaceutical. The other authors declare that they have no conflict of interest.

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