Previous studies have demonstrated that both gefitinib and erlotinib are markedly effective for the treatment of non-small-cell lung cancer (NSCLC) with somatic activating mutations of the epidermal growth factor receptor gene (EGFR-mt). These agents are considered to act on EGFR through the same mechanism. However, the efficacy of these agents against EGFR wild-type (-wt) NSCLC remains unclear, and the frequency of adverse events (AEs) appears to differ between them at each approved dose. Here, we conducted a retrospective analysis of AEs and drug efficacy in patients with NSCLC whose EGFR mutation status had been confirmed and who all received 250 mg gefitinib or 150 mg erlotinib once daily. The erlotinib group (n = 35) had more AEs, including rash, fatigue, stomatitis, anorexia and constipation. On the other hand, liver dysfunction and nail change were more frequent in the gefitinib group (n = 107). AEs of ≥grade 2, including rash, fatigue and nausea, were more frequent in the erlotinib group. The erlotinib group also showed more of a tendency to require dose reduction due to AEs. With regard to treatment efficacy for patients with EGFR-wt, there was no significant difference in progression-free survival between the two drug groups. However, this study has several limitations as of the nature of retrospective design; our data suggest that gefitinib and erlotinib might have almost equal efficacy for patients with EGFR-wt NSCLC, as is the case for patients with EGFR-mt tumors, although erlotinib appears to have higher toxicity than gefitinib at each approved dose.

译文

:以前的研究表明,吉非替尼和厄洛替尼均对具有表皮生长因子受体基因(EGFR-mt)的体细胞激活突变的非小细胞肺癌(NSCLC)具有显着疗效。这些试剂被认为通过相同的机制作用于EGFR。但是,这些药物对EGFR野生型(-wt)NSCLC的疗效仍不清楚,并且在每次批准的剂量下,它们之间的不良事件(AEs)频率也有所不同。在这里,我们对NSCLC患者的AEs和药物疗效进行了回顾性分析,这些患者的EGFR突变状态已得到确认,并且均每天接受250 mg吉非替尼或150 mg厄洛替尼治疗。厄洛替尼组(n = 35)具有更多的不良事件,包括皮疹,疲劳,口腔炎,厌食和便秘。另一方面,吉非替尼组(n = 107)更常出现肝功能障碍和指甲更换。厄洛替尼组≥2级的AE,包括皮疹,疲劳和恶心。埃洛替尼组还显示出更多由于AE导致需要减少剂量的趋势。关于EGFR-wt患者的治疗效果,两组药物的无进展生存期无显着差异。然而,由于回顾性设计的性质,该研究存在一些局限性。我们的数据表明,吉非替尼和厄洛替尼对EGFR-wt NSCLC患者的疗效几乎相同,而EGFR-mt肿瘤患者也是如此,尽管在每个批准的剂量下厄洛替尼似乎比吉非替尼具有更高的毒性。

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