Short-Term Gefitinib Treatment Brought About a Long-Term Regression of Bronchioloalveolar Carcinoma Without EGFR Gene Alterations: A Case Report

Authors: Kijima, Takashi¹; Suzuki, Mayumi¹; Ueda, Kayo²; Minami, Seigo¹; Takeda, Yoshito¹; Goya, Sho¹; Matsuoka, Hiroto¹; Kumagai, Toru¹; Yoshida, Mitsuhiro¹; Osaki, Tadashi¹; Tachibana, Isao¹; Yokota, Soichiro³; Kawase, Ichiro¹

Source: Oncology Research Featuring Preclinical and Clinical Cancer Therapeutics, Volume 16, Number 10, 2007 , pp. 489-495(7)

Publisher: Cognizant Communication Corporation

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Abstract:

The tyrosine kinase inhibitor (TKI) of the epidermal growth factor receptor (EGFR) gefitinib has beneficial effect in some patients with refractory advanced non-small cell lung cancer (NSCLC). However, the majority of responders eventually develop acquired resistance during the course of prolonged continuous treatment. Here we present a case of 76-year-old Japanese female, who had never smoked, with poor performance status from bronchioloalveolar carcinoma (BAC), in whom a brief initial 5-week administration of gefitinib resulted in dramatic antitumor effects that lasted approximately 8.5 months after cessation of the treatment. Furthermore, the relapsed tumor later regressed again by re-treatment with the TKI. She survived 26 months since she first took gefitinib. Unexpectedly, neither sensitizing mutations for EGFR-TKIs nor increased copy numbers were detected in EGFR gene of her BAC cells. This case suggests that, in some patients with NSCLC, even short-term administration of gefitinib may bring about clinical benefits and disease response comparable to the standard long-term daily dosing schedule. Short-term use of gefitinib will also be able to minimize the expensive medical cost of the TKI. The potential role of short-term or pulse-dose therapy with EGFR-TKIs should be clarified in further prospective studies. Moreover, it is urgent to develop better strategies by which we could distinguish responders to the TKIs from nonresponders among patients who do not have any EGFR gene alterations.

Keywords: Bronchioloalveolar carcinoma; Epidermal growth factor receptor; Gefitinib; Re-treatment; Acquired resistance; Short-term treatment

Document Type: Research article

DOI: http://dx.doi.org/10.3727/096504007783338313

Affiliations: 1: Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Osaka 565-0871, Japan 2: Department of Pathology, National Hospital Organization Toneyama National Hospital, Osaka 560-8552, Japan 3: Respiratory Medicine, National Hospital Organization Toneyama National Hospital, Osaka 560-8552, Japan

Publication date: 2007-10-01

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Formerly: Oncology Research Incorporating Anti-Cancer Drug Design
Oncology Research Featuring Preclinical and Clincal Cancer Therapeutics publishes research of the highest quality that contributes to an understanding of cancer in areas of molecular biology, cell biology, biochemistry, biophysics, genetics, biology, endocrinology, and immunology, as well as studies on the mechanism of action of carcinogens and therapeutic agents, reports dealing with cancer prevention and epidemiology, and clinical trials delineating effective new therapeutic regimens.

Short-Term Gefitinib Treatment Brought About a Long-Term Regression of Bronchioloalveolar Carcinoma Without EGFR Gene Alterations: A Case Report

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