Effect of Gefitinib Combined with Paclitaxel on Quality of Life and Survival in Patients with NSCLC

doi:10.19803/j.1672-8629.2021.06.14

Abstract

Abstract: Objective To investigate the effect of gefitinib combined with paclitaxel on the quality of life and survival of patients with advanced non-small cell lung cancer (NSCLC), and analyze its clinical value. Methods Ninety patients with advanced NSCLC admitted to our hospital were randomly divided into the observation group and control group. The control group was treated with albumin binding paclitaxel and cisplatin, while the observation group was additionally given gefitinib. The clinical efficacy, adverse reactions, quality of life and changes of cancer markers were compared between the two groups. Results After 3 months of treatment, the effective rate and disease control rate of the observation group were 55.56% and 84.44% respectively, which were higher than 22.22% and 60.00% of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P<0.05). After 6 months of treatment, the quality of life in the two groups was improved, and the scores of SF-36 in each field in the observation group were higher than those of the control group (P<0.05) in the same period. After 3 months of treatment, levels of CEA, CA50 and CA125 in the two groups decreased. After 6 months of treatment, the above indexes in the observation group were lower than those of the control group (P<0.05). The progression free survival time and 3-year survival rate of the observation group were (5.97±0.88) months and 42.22% respectively, which were higher than (3.62±0.74) months and 24.44% in the control group (P<0.05). Conclusion Combined with albumin binding paclitaxel and cisplatin chemotherapy, gefitinib can significantly improve the quality of life, prolong the survival of patients with advanced NSCLC, and achieve a better clinical effect while ensuring the safety of treatment.

Key words: gefitinib, albumin binding paclitaxel, non-small cell lung cancer, quality of life

CLC Number:

R979.1

CAO Hongli, YU Panpan, YANG Jing, XI Jianing. Effect of Gefitinib Combined with Paclitaxel on Quality of Life and Survival in Patients with NSCLC[J]. Chinese Journal of Pharmacovigilance, 2021, 18(6): 562-565.

References

[1] Zhong WZ, Wang Q, Mao WM, et al.Gefitinib versus vinorelbine plus cisplatin as adjuvant treatment for stage II-IIIA (N1-N2) EGFR-mutant NSCLC (ADJUVANT/CTONG1104): a randomised, open-label, phase 3 study[J]. The Lancet Oncology, 2018, 19(1): 139-148.
[2] Yue J, Lgu D, Wang C, et al.Epigenetic silencing of miR-483-3p promotes acquired gefitinib resistance and EMT in EGFR-mutant NSCLC by targeting integrin β3[J]. Oncogene, 2018, 37(31): 4300-4312.
[3] Hosomi Y, Morita S, Sugawara S, et al.Gefitinib alone versus gefitinib plus chemotherapy for non-small-cell lung cancer with mutated epidermal growth factor receptor: NEJ009 study[J]. Journal of Clinical Oncology, 2020, 38(2): 115-123.
[4] Sutiman N, Tan SW, Tan EH, et al.EGFR mutation subtypes influence survival outcomes following first-line gefitinib therapy in advanced Asian NSCLC patients[J]. Journal of Thoracic Oncology, 2017, 12(3): 529-538.
[5] Sun YP, Niu RG, Liu XX, et al.Effect of gefitinib on advanced non-small cell lung cancer with different EGFR site mutations[J]. Cancer Research and Clinical(肿瘤研究与临床), 2019, 31(5): 315-319.
[6] Xue YH, Wang LC, Hu LL, et al.Clinical efficacy and safety evaluation of nedaplatin or cisplatin combined with gemcitabine in the treatment of advanced NSCLC[J]. Chinese Journal of Pharmacovigilance(中国药物警戒), 2018, 15(3): 12-15.
[7] Li X, Zhang X, Yang C, et al.The lncRNA RHPN1-AS1 downre-gulation promotes gefitinib resistance by targeting miR-299-3p/TNFSF12 pathway in NSCLC[J]. Cell Cycle, 2018, 17(14): 1772-1783.
[8] Li Q, Zhang JK, Liu ZH, et al.Clinical observation of gefitinib and chemotherapy in maintenance treatment of advanced non-small cell lung cancer[J]. International Medical and Health Guide(国际医药卫生导报), 2017, 23(16): 2568-2573.
[9] Kani K, Garri C, Tiemann K, et al.JUN-mediated downregulation of EGFR signaling is associated with resistance to gefitinib in EGFR-mutant NSCLC cell lines[J]. Molecular Cancer Therapeutics, 2017, 16(8): 1645-1657.
[10] Yang JCH, Gadgeel SM, Sequist LVD, et al.Pembrolizumab in combination with Erlotinib or Gefitinib as first-line therapy for advanced NSCLC with sensitizing EGFR mutation[J]. Journal of Thoracic Oncology, 2019, 14(3): 553-559.
[11] Zhao L, Lin T.The relationship between K-ras gene mutation and the effect of gifetinib in the treatment of advanced non-small cell lung cancer[J]. Chinese Journal of Experimental Surgery(中华实验外科杂志), 2019, 36(3): 445-445.
[12] Tan EH, Lim WT, Ahn MJ, et al.Phase 1b trial of ficlatuzumab, a humanized hepatocyte growth factor inhibitory monoclonal antibody, in combination with gefitinib in Asian patients with NSCLC[J]. Clinical Pharmacology in Drug Development, 2018, 7(5): 532-542.
[13] Zhang JB, Gao YF.Effect observation of hydroxycamptothecin pericardial perfusion combined with gefitinib in the treatment of advanced non-small cell lung cancer with pericardial effusion[J]. Chinese Basic Medicine(中国基层医药), 2019, 26(8): 968-971.
[14] Ma Y, Xin S, Huang M, et al.Determinants of Gefitinib toxicity in advanced non-small cell lung cancer (NSCLC): a pharmaco-genomic study of metabolic enzymes and transporters[J]. The Pharmacogenomics Journal, 2017, 17(4): 325-330.
[15] Zhu C, Cai ZA, Li XY, et al.Clinical study of gefitinib combined with concurrent thoracic radiotherapy in the treatment of locally advanced non-small cell lung cancer with sensitive gene mutation[J]. China Basic Medicine(中国基层医药), 2019, 26(8): 943-948.
[16] Cho JH, You YM, Yeom YI, et al.RNF25 promotes gefitinib resistance in EGFR-mutant NSCLC cells by inducing NF-κB-mediated ERK reactivation[J]. Cell Death & Disease, 2018, 9(6): 1-13.
[17] Tan J, Li M, Zhong W, et al.Tyrosine kinase inhibitors show different anti-brain metastases efficacy in NSCLC: A direct comparative analysis of icotinib, gefitinib, and erlotinib in a nude mouse model[J]. Oncotarget, 2017, 8(58): 98771.
[18] Zheng Y.Effect of gefitinib combined with DP chemotherapy regimen combined with 3D-CRT on serum SCCAg, bFGF levels and survival cycle of patients with locally advanced non-small cell lung cancer[J]. International Journal of Medicine and Health(国际医药卫生导报), 2018, 24(13): 1974-1978.