Treatment failure patterns of adjuvant gefitinib therapy and minimal residual disease detection in resected EGFR-mutant non-small cell lung cancer: author’s reply

We appreciate the remarks on our recent ADJUVANT publication of comparing spatial and temporal recurrence patterns between gefitinib and VP (vinorelbine plus cisplatin) chemotherapy in selected stage II–IIIA NSCLC patients with activating EGFR mutations. The recurrent model is very important for early non-small cell lung cancer (NSCLC) treated with curative procedure that could guide making future treatment strategy to cure disease. In our manuscript we built a new analytical method based on hazard ratios that showed the unique spatial-temporal recurrent patterns. In gefitinib group, we observed that recurrence risk increased at a constant rate 12 months post- surgery. It could be inferred that gefitinib could not kill tumor cells in these patients. The highest peak occurred at 30 months post-surgery. All of these indicated adjuvant EGFR TKI prolongs and reduces the recurrence or metastasis at space and timing for completely resected N1– N2 NSCLC (1).