Monday, December 21, 2009
MONDAY, Dec. 21 (HealthDay News) -- In the treatment of non-small-cell lung cancer (NSCLC), gefitinib, an epidermal growth factor receptor (EGFR) inhibitor, may provide longer progression-free survival as compared to standard platinum doublet chemotherapy with cisplatin and docetaxel, according to a Japanese study published online Dec. 21 in The Lancet.
Tetsuya Mitsudomi, M.D., of the Aichi Cancer Center Hospital in Nagoya, Japan, and colleagues assessed progression-free survival in 177 chemotherapy-naïve, stage IIIB/IV NSCLC patients with EGFR mutations, including an exon 19 deletion or L858R point mutation. Patients were randomized to receive either gefitinib or cisplatin plus docetaxel for three to six cycles.
Of the 172 patients included in the survival analysis, the researchers found that patients receiving gefitinib experienced longer progression-free survival as compared to those receiving cisplatin plus docetaxel (9.2 versus 6.3 months). The adverse effects among patients receiving gefitinib included skin toxicity, liver dysfunction and diarrhea, while patients receiving doublet chemotherapy experienced more frequent myelosuppression, alopecia and fatigue. In addition, one of the two patients receiving gefitinib who developed interstitial lung disease died.
"Gefitinib significantly prolonged the progression-free survival of patients with NSCLC who carry EGFR mutations compared with cisplatin plus docetaxel," the authors write. "It is not yet known whether the prolonged progression-free survival conferred by gefitinib will translate into prolonged overall survival."
Several authors reported financial and consulting relationships with AstraZeneca (gefitinib manufacturer) and other pharmaceutical companies. The study was supported by West Japan Oncology Group, a company supported by the pharmaceutical industry.
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