Treatment after the Failure of Gefitinib in Patients with Advanced or Recurrent Non-small Cell Lung Cancer

Background: The optimal treatment for patients with progressive non-small cell lung cancer who initially show a good response to gefitinib is unclear. Patients and Methods: This study retrospectively analyzed 60 consecutive patients who experienced treatment failure after achieving disease control with gefitinib and thereafter underwent post initial gefitinib treatment either with or without continuing gefitinib. Results: Continuing gefitinib was independently associated with a good survival based on multivariate analyses (hazard ratio (HR)=0.51; 95% confidence interval (CI) =0.26-0.98; p=0.0426), and performance status at the failure of gefitinib (0.05; 0.02-0.17; p<0.0001). The adjusted HR of continuing gefitinib based on Cox regression analysis and a propensity score of 0.61 (95% CI, 0.41-0.92) indicated an association between a prolonged survival and the continuation of gefitinib. Conclusion: In addition to post gefitinib treatment, continuing the administration of gefitinib should be considered in patients who previously achieved disease control with gefitinib, even after a failure of gefitinib.