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Adjuvant Treatments Compared for EGFR-Mutant Lung Cancer

By: Andrew Goldstein
Posted: Friday, January 12, 2018

Patients with completely resected EGFR-mutant stage II–IIIA (N1–N2) non–small cell lung cancer (NSCLC) experienced significantly longer disease-free survival when given adjuvant gefitinib compared with vinorelbine plus cisplatin. This finding is based on the randomized, open-label, phase III ADJUVANT trial (NCT01405079), conducted by Wen-Zhao Zhong, MD, PhD, of the Guangdong Lung Cancer Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, and colleagues and published in The Lancet Oncology.

Between September 2011 and April 2014, 222 patients between the ages of 18 and 75 were randomized, with half receiving gefitinib and half receiving vinorelbine plus cisplatin. The median disease-free survival for patients treated with gefitinib was 28.7 months compared with 18 months for those treated with vinorelbine plus cisplatin.

Two patients in the gefinitib group (2%) experienced grade 3 or worse raised alanine aminotransferase levels, and another two patients experienced grade 3 or worse raised aspartate aminotransferase levels. In the vinorelbine group, grade 3 or worse events occurred in 30 patients (34%) who experienced neutropenia, 14 (16%) who experienced leukopenia, and 8 (9%) who experienced vomiting. Serious adverse events were reported in 7 (7%) patients who received gefitinib and 20 (23%) patients who received vinorelbine plus cisplatin.