| Background The study aimed to compare the efficacy and tolerability clinical outcomes of gefitinib combined with chemotherapy agents therapy versus chemotherapy alone for the treatment of epidermal growth factor receptor-mutated lung adenocarcinoma among metastatic or recurrent advanced and heavily pretreated patients.Methods To minimize intergroup heterogeneity the study was designed as a matched-pair case-control investigation. Patients were stratified into gefitinib combined chemotherapy and chemotherapy alone groups with matching according to sex, age(<65 years old vs.>65 years old), ECOG performance status(0 vs.1 vs.2), progress-free survival (PFS) from previous EGFR tyrosine kinase inhibitor treatment, EGFR mutation types, and tumor metastasis status.Results By using the matched-pair method 66 patients were selected from our database. The median age was 61 years (95% confidence interval, 57-65 years). During a follow-up period of 14.5 months on average, the overall response rates of the gefitinib-integrated and chemotherapy alone groups were 9.1% and 6.5%, respectively (P>0.05), and the corresponding disease-control rates were 39.4% and 30.3%, respectively (P>0.05). No statistically significant differences in PFS (median,4.2 vs.3.3 months; P= 0.06) and overall survival (median,10.4 vs.7.9 months; P= 0.44) were observed between the two groups. The 6-month survival rates of the gefitinib-integrated and chemotherapy alone groups were 21.2% and 12.1%, respectively (P<0.05). Side effects were mild, and all treatments were well tolerated.Conclusion Our results indicated that gefitinib-integrated therapy offered a trend to better PFS and an improved 6-month survival rate in heavily pretreated patients with metastatic EGFR-mutated lung adenocarcinoma. All treatments were well tolerated. Future prospective studies are warranted to confirm our findings. |
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