Efficacy of gefitinib versus erlotinib as first-line treatment in EGFR mutant advanced lung adenocarcinoma at RSP Dr. H. A. Rotinsulu

Abstract

Background: Gefitinib and erlotinib are superior to chemotherapy, and are considered first-line therapies in adenocarcinoma with epidermal growth factor receptor (EGFR) mutation patients. However, the determination of the choice of gefitinib or erlotinib is not yet clear.

Aim: To compare the progression-free survival (PFS), overall survival (OS) and time on treatment (TOT) of adenocarcinoma with EGFR mutation patients who receiving first-line gefitinib versus erlotinib.

Methods: This is a retrospective study used medical record of patients who were treated with first-line gefitinib 250 mg once daily versus erlotinib 150 mg once daily at Dr. H.A. Rotinsulu Lung Hospital from 1^st January 2019 to 31^th December 2021.

Results: There are 103 patients (74,1%) who received gefitinib and 36 patients (25,9%) who received erlotinib as first-line treatment. Median PFS in gefitinib and erlotinib group was 26 months and 17 months (P=0,184), respectively. Median overall survival time of the gefitinib group was the 46,78 months but in erlotinib group cannot be analysed. Median time-of-treatment was 12 months in gefitinib group and 11 months in erlotinib group (P=0,172). The incidence rate ratio in the TKI group did not show a causal relationship with death due to IRR values of 0,74 and 95% CI IRR of 0,21;3,24. Based on univariate analysis, gender affects PFS (HR1,7;CI95%;1,0-3,4;P=0,049) and TOT (HR1,6;CI95%;1,1-2,6;P=0,020). The data also showed that age affects TOT (HR1,5;CI95%;1,0-2,4;P=0,037).

Conclusion: There was no difference in efficacy between gefitinib and erlotinib in the treatment of pulmonary adenocarcinoma patients with EGFR gene mutations at Dr. H.A. Rotinsulu Lung Hospital.