Efficacy and Survival-associated Factors with Gefitinib Combined with Cisplatin and Gemcitabine for Advanced Nonsmall Cell Lung Cancer

Objective: To analyze the efficacy and survival associated factors of gefitinib combined with cisplatin andgemcitabine for advanced non-small cell lung cancer. Materials and
Methods: A total of 57 patients with advancednon-small cell lung cancer (NSCLC), who received platinum-based chemotherapy regimens for more than 1 cycle,were treated with gefitinib combined with cisplatin and gemcitabine until disease progression. Efficacy, survivaltime and adverse reactions were observed. The Kaplan-Meier method was adopted for analysis of survival andCox regression for associated influencing factors.
Results: The patients were followed up until October 31, 2013,and the median follow-up time was 19 months. Of 57 patients, there were 4 (7.0%) with complete remission (CR),8 (14.0%) with partial remission, 31 (54.4%) with stable disease, and 14 (24.6%) with disease progression. Theremission rate was 21.1% and the disease control rate was 75.4%. The median progression-free survival (PFS)time and the median overall survival time were 10 months and 15.2 months. The one-year, two-year and threeyearsurvival rates were 47.4%, 23.3% and 10.0%. Gender and pathological types were the independent riskfactors influencing PFS time (P=0.028, P=0.009). Tumor pathological type and early efficacy were independentfactors for the prognosis (P=0.018, P=0.000). Adverse reactions were mostly rashes of Ⅰ~Ⅱ degree and diarrheaand slightly increasing level of aminopherase. The skin adverse event incidence of Ⅲ degree or above was1.8% (1/57) and brain metastasis was foudn in 31.6% (18/57).
Conclusions: Gefitinib combined with cisplatinandgemcitabine, is effective for patients with Ⅲb~Ⅳ NSCLC who received multiple cycles of chemotherapy.