1. ¹Department of Medical Oncology, National Cancer Centre, 11 Hospital Drive, Singapore 169610, Singapore
2. ²Division of Clinical Trials and Epidemiological Sciences, National Cancer Centre, Singapore, Singapore
3. ³Department of Pathology, Singapore General Hospital, Singapore, Singapore

Correspondence: Dr E-H Tan, Department of Medical Oncology, National Cancer Centre, 11 Hospital Drive, Singapore 169610, Singapore. E-mail: dmoteh@nccs.com.sg

Received 11 February 2005; Revised 5 May 2005; Accepted 6 May 2005; Published online 7 June 2005.

Abstract

We retrospectively analysed the results of patients with advanced non-small-cell lung cancer treated with gefitinib to derive clinical factors predictive of response and a favourable survival outcome. Patients were treated with gefitinib 250 mg per day and re-evaluated 4–8 weeks later with repeat CT scan and every 8 weeks thereafter to assess response and the duration of response. Pathology review by a histopathologist was conducted, in particular to confirm a recently published result of bronchioloalveolar carcinoma histology or its components as predictive of response to gefitinib. Logistic regression and Cox regression analytical methods were applied to determine factors that could predict for response and improved overall survival. A total of 110 patients were treated. The overall response rate was 32% partial responses (PRs). Only never-smoking status was predictive of response in the logistic regression analysis, adjusted OR=6.1, 95% CI=1.7, 21.5. The presence of a PR and good performance status were predictive of a favourable survival outcome from the Cox regression modelling. Responders had an adjusted HR of 3.0, 95% CI=1.5–5.8 compared to nonresponders, while patients with ECOG status 0–1 had an adjusted HR of 0.42, 95% CI=0.25–0.72, compared with patients with ECOG status 2–4. Bronchioloalveolar carcinoma or its components were distinctly absent on pathology review. In conclusions, Never-smoking status is an important clinical predictor of a favourable response to gefitinib.