Age, sex, cigarette smoking history, gene mutation, overall performance statuses, response rate, PFS2 (the PFS in salvage therapy), and overall survival (OS2, the OS in salvage therapy) were recorded. Results Two hundred and nine patients with mutated and who took gefitinib as first-line therapy were recognized in the period, and a total of 98 patients who had been treated with salvage therapy with cytotoxic chemotherapy or erlotinib were eligible for this study. pattern for better PFS2 than those who received erlotinib (4.3 months vs 3.0 months, were discovered Rabbit polyclonal to Aquaporin10 in non-small-cell lung cancer (NSCLC), and these mutations have been found to be strongly associated with the susceptibility to mutation status), these studies showed variable outcomes and are, therefore, hard to be applied to the daily clinical practice. After being covered as the first-line therapy to treat advanced lung adenocarcinoma harboring mutation by the National Health Insurance since June 2011, gefitinib has been the most popular first-line mutation who experienced disease progression during gefitinib treatment. This study exhibited the real-world data of the second-line salvage therapy in patients with gene were analyzed using an RGQ kit (Qiagen NV, Venlo, the Netherlands), which utilized amplification refractory mutation-specific polymerase chain reactions and Scorpion technologies for detection and/or direct sequencing. The detection method was developed and validated by the Division of Molecular Diagnostics, Department of Laboratory Medicine, KMUH. An initial treatment response was classified as total response (CR), partial response (PR), stable disease, or progressive disease based on serial imaging studies using the revised Response Evaluation Criteria in Solid Tumors (RECIST 1.1) criteria.16 The response rate and disease control rate were defined as the percentages of 2-Hydroxyadipic acid patients with CR and PR and with CR, PR, and stable disease, respectively. The second-line salvage therapy included erlotinib and cytotoxic chemotherapy, including pemetrexed, gemcitabine, vinorelbine, and taxanes (docetaxel), with or without platinum derivatives (cisplatin or carboplatin). The duration between the start of the second-line treatment to the date of disease progression thereafter and to the date of death were defined as PFS2 and overall survival (OS2). The Institutional Review Table (IRB) of KMUH approved this study 2-Hydroxyadipic acid (KMUHIRB-E[II]-20150162) and waived the need for written informed consent from your participants due to the retrospective nature of this study. Statistical analysis Age, sex, smoking history, gene mutation site (exon 18, exon 19, and exon 21), thyroid transcription factor 1 immunostaining, metastatic sites on initial diagnosis, overall performance statuses when starting the treatments, and initial treatment responses were summarized and compared between patients receiving different second-line treatments. Categorical variables and continuous variables were compared using the gene mutations who had been treated with gefitinib as the first-line treatment were recognized. After excluding those who remained on gefitinib treatment and those who did not received erlotinib or cytotoxic chemotherapy as the second-line treatment after gefitinib failure, the remaining 98 patients were included for analyses. As shown in Table 1, 12 (12%), 26 (27%), and 60 (61%) patients received erlotinib, chemotherapy without platinum, and platinum-based doublet as their second-line treatment after gefitinib failure, respectively. In the 60 patients who received platinum-based doublet, 34 (57%) of them received pemetrexed (Table 1). Table 1 Regimens used as the second-line treatment after gefitinib failure mutation and developed an acquired resistance to the initial mutation who developed acquired resistance to the first-line gefitinib treatment, cytotoxic chemotherapy seemed more effective than a subsequent mutation. As a result, most of these patients received gefitinib as the first-line therapy in Taiwan. Despite gefitinib showed good efficacy and 2-Hydroxyadipic acid longer PFS than cytotoxic chemotherapy in this populace, acquired resistance to mutation status).10,14,15,19 Kuo et al showed that patients who received cytotoxic chemotherapy had better PFS and OS than those who just received best supportive care. Furthermore, they also indicated that patients who received taxane-based subsequent chemotherapy exhibited a higher response rate (48.7%), higher disease control rate (79.5%), longer PFS (median: 5.1 months), and longer OS (median: 12.7 months) than those who received non-taxane-based regimens, including pemetrexed-based therapy.14.