Gefitinib for Lung Cancer Non-Small-Cell

The results of a meta-analysis revealed that oral gefitinib, a tyrosine kinase inhibitor class of drugs, is effective as first-line therapy in patients living with lung cancer non-small-cell tumor whose cells contain the EGFR mutations (epidermal growth factor receptor). Early treatment with gefitinib produces ORR (objective response rate) and PFS (progression-free survival) is better, as well as the toxicity profile and quality of life, when compared with chemotherapy. The results of Dr.. Geoffrey Y. Ku and colleagues, from Johns Hopkins Singapore International Medical Center, is published online on Lung Cancer in May 2011.


Researchers explained that Asian women living with lung cancer who never smoked will clearly benefit from the preferential tyrosine kinase inhibitor therapy, plus the finding of EGFR mutations in this patient population. Based on these observations, conducted this phase III randomized study to compare the efficacy of gefitinib with chemotherapy as first-line therapy in patients of East Asia lung cancer non-small-cell stage.

In a recent study, scientists performed a meta-analysis of four studies to measure the benefits and toxicity of gefitinib when compared with chemotherapy. A total of 1860 patients were randomized and divided into groups of gefitinib and the chemotherapy group. All participants are known, or clinically suspected, the mutated EGFR. Fatigue, nausea, and mielosupresi were significantly more experienced by patients who were given chemotherapy than those who received gefitinib. On the other hand, rash and diarrhea were more common in the gefitinib group. Quality of life scores on the three instruments were significantly better in the gefitinib group than the chemotherapy group (odds ratio 1.34, 1.78, and 1.13). PFS is better in the gefitinib group than the chemotherapy group (hazard ratio 0.45), but overall survival did not differ significantly between the two groups.

Lack of benefit in overall survival indicated that patients with good clinical condition can be given chemotherapy or gefitinib. However, the researchers argue that many patients and physicians who would choose gefitinib as first-line therapy because of superior tolerability.