The BC Cancer Agency experience with gefitinib in advanced non-small cell lung cancer (NSCLC)
Bibliographic record
Abstract
3104 Background: Institutional series suggest specific patient subgroups; female, Asian, non-smokers, respond preferentially to gefitinib. Vancouver, BC, has a large Asian population and therefore is an ideal location to study this differential effect. We performed a retrospective analysis of patients treated with single agent gefinitib to determine if our experience reflects this observation. Methods: Between April 2002 and August 2003, 31 patients were treated with gefitinib. Pathology, radiology, laboratory investigations and clinical records were reviewed. Partial radiologic response was defined as per SWOG response criteria. Symptom responses were subjectively evaluated from chart review. Tumor markers assessed included CEA, Ca 15.3, Ca 19–9 and Ca 125. Results: Baseline characteristics at diagnosis; 61% Caucasian, 39% Asian, male 45%, smokers 55%, non-smokers 39%, ECOG 0/1 87%. The tumor histology: 55% adenocarcinoma, 19% bronchoalveolar variant, 6.5% large cell, 3% squamous, 16.5% other. Median treatment length was 2 months. On radiologic review, 6 patients had a response, 13 had stable disease, 9 progressed, and 3 unknown. Fourteen patients reported improved symptoms, 6 had no change, and 9 had symptom progression. Tumor marker data was available in 18 patients: 7 had decrease in marker values, 4 had marker stabilization, and 7 had an increase. Toxicity was minimal; 1 patient had grade 3 hepatotoxicity that resolved with treatment cessation. There were 5 Asian female non-smokers; 2 had a response, 2 had stable disease and 1 progressed. Of the 6 radiological responders, 5 had ECOG 0/1, 4 were female, 5 non-smokers, 4 adenocarcinoma and 2 bronchoalveolar variant. A multivariate analysis of radiologic responders and those with stable disease is underway. Conclusions: At the BCCA, in a select number of patients with advanced NSCLC, gefitinib demonstrated clinical and radiologic anti-tumor benefit with minimal side effects. The molecular basis of the improved response rate observed in the subset of female, Asian, non-smokers with adenocarcinoma or bronchoalveolar variant warrants further exploration. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".