Objective The standard therapy after failure of the initial non-first line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment in advanced non-small cell lung cancer(NSCLC) has not yet been established.The aim of the current study was to identify whether the 2 TKI treatment or chemotherapy(paclitaxel-containing or non-paclitaxel regimen) is the appropriate treatment for patients with NSCLC based on the efficacy of the initial TKIs. Methods Seventy-two advanced NSCLC patients who had accepted 2 TKIs or chemotherapy immediately after failure of the initial TKIs in non-first line setting from May 1,2004 to January 31,2010 at the Sun Yat-sen University Cancer Center were enrolled.The primary endpoint[2 progression-free survival(PFS)]and the second endpoint[overall survival(OS)]were compared among the 2 TKI and chemotherapy groups as well as their subgroups. Results(1) Twenty-one patients were treated with 2 TKIs,and 51 patients were administered chemotherapy after failure of the initial non-first line TKI treatment.There was nonsignificant difference in the responses(P=0.900)[2 PFS(P=0.833) and OS(P=0.369)] between the 2 TKI and chemotherapy groups.(2) In the 2 TKI group,9 patients exhibited PFS>7 months.The initial TKI treatment group exhibited a longer 2 PFS than the other 12 patients with an initial PFS<7 months(7 months vs.2 months,P=0.019).However, these groups had nonsignificantly different OS(P=0.369).(3) In the chemotherapy group,patients with PFS<5 months exhibited longer 2 PFS than those with PFS > 5 months in the initial TKI treatment(3 months vs.2 months,P=0.039).(4) In the chemotherapy group, patients treated with paclitaxel-containing regimen showed longer 2 PFS than those treated with non-paclitaxel regimen(5 months vs.2.3 months,P=0.043). Conclusions Patients with PFS>7 months or <5 months under the initial TKI treatment potentially benefit from the 2 TKI treatment or chemotherapy immediately after failure of the non-first line TKIs.The paclitaxel-containing regimen may imp
Objective: We aimed to evaluate the effect of bevacizumab in the palliative treatment of Chinese metastatic colorectal cancer(mCRC) and its efficacy in different lines. Methods: Patients of mCRC treated with bevacizumab or not at Sun Yat-sen University Cancer Center from 2005 to 2013 were recruited as the study group and control group. The endpoints were objective response rate(ORR), disease control rate(DCR), overall survival(OS) and progression free survival(PFS). The OS and PFS of first-, second- and third-line treatment groups were compared between study group and control group. Results: The median PFS of the study and the control group were 8.2 months(7.0–9.4 months), 5.7 months(4.7–6.6 months), P = 0.001; OS were 26 months(5.4–130.5 months), 18 months(16.6–19.4 months), P < 0.001, respectively. The ORR and DCR of first-, second- and third-line were 30.3%(20/66), 20%(6/30), 17.6%(3/17) and 97%(64/66), 86.7%(26/30), 100%(17/17). In the first-line chemotherapy group, the OS of the study group and the control group were 22.9(5.4–96.7) months and 18(16.6–19.4) months(P < 0.001); PFS were 9.4(8.4–10.4) months and 5.7(4.7–6.6) months(P < 0.001), respectively. While in the second- and third-line setting, only OS were statistically different, PFS had no significant difference. Conclusion: The combination of bevacizumab and chemotherapy had a promising short-term and long-term efficacy in Chinese mCRC patients than those without bevacizumab regimens, and the effect could be better reflected in the first-line treatment.
