A Retrospective Review Of The Efficacy Of Gefitinib In The Treatment Of Nsclc In Lebanon.

3217 Background: Gefitinib (Iressa) is a tyrosine kinase inhibitor belonging to the anilinoquinazoline class of compounds. It acts to inhibit the effect of EGFR, long recognized as the cellular homologue of the viral oncogene v-erb. Study Design: This study is a multi-center, retrospective review that aims to evaluate the Lebanese experience with gefitinib in the treatment of non-small cell lung cancer. Results: Among the 50 patients the mean age was 61 (median 64) 72% were male and 28% female. As for histological type, 15 patients (44.1%) had adenocarcinoma, 12 (35.3%) had squamous cell carcinoma, 2 (5.9%), 3(8.8%) and 2(5.9%) had non-small cell lung carcinoma, large cell, and epidermoid types respectively. 27 patients (54%) underwent radiation therapy and 12 (24%) had prior surgery. 45 patients (90%) had prior conventional chemotherapy which contained cisplatin in 35 (70%). 18 patients (36%) had 1 chemotherapy regimen before Iressa, 18 (36%) had 2 regimens, while 8 (16%) had 3 or more. Response rates to gefitinib were as follows: Complete response 2 patients (4%), partial response 4 (8%), with an overall response rate of 12%, stable disease 12 (24%) and progressive disease 29 (58%). When stratified by histology type, 14 patients had adenocarcinoma. Of those 1 had complete response, 2 had stable disease and 11 progressive disease while on gefitinib. Of the 25 patients who had ECOG functional status 0 or 1, 11 (44%) had disease progression vs 12 of the 15 patients (80%) who had ECOG functional status of 2 or more. (p = 0.046). This didn’t translate into survival benefit however with a survival time of 34 ± 7 months for ECOG functional status of 0 and 1 and 21± 4 months for ECOG functional status of 2 and above (p = 0.213). Conclusion: Despite the fact that the response rate to gefitinib is rather low (12%) it is higher for patients with ECOG functional status of 0 and 1 (p = 0.046) with a trend to improve survival among these patients (34 ± 7 vs 21± 4 months). No significant financial relationships to disclose.