Three cases of long-lasting tumor control with erlotinib after progression with gefitinib in advanced non-small cell lung cancer

Introduction: We report the cases of three patients with advanced non-small cell lung cancer responding to erlotinib after progression under gefitinib treatment. Methods: Three never-smoker women with advanced lung adenocarcinoma, two pretreated with chemotherapy and with gefitinib and one with gefitinib alone, received erlotinib in a daily dose of 150 mg. All three patients had disease progression and had achieved tumor control with gefitinib. Results: The first patient achieved partial response of lung lesions, the second had partial response of brain lesions and stable disease of lung and bone disease, and the third had partial response of brain lesions and stable disease of lung disease. At the time of this analysis, all three patients were still receiving treatment with erlotinib with no evidence of treatment failure after more than 13, 13, and 7 months, respectively. Erlotinib was generally well tolerated, with grade I skin toxicity recorded in two patients. Conclusions: Erlotinib may be effective in patients with non-small cell lung cancer who were previously and successfully treated with gefitinib. However, careful selection of these patients is needed.