WEDNESDAY, June 23 (HealthDay News) -- Gefitinib, a tyrosine kinase inhibitor of the epidermal growth factor receptor (EGFR), is more effective than standard chemotherapy in extending life for patients with non-small-cell lung cancer (NSCLC) who have EGFR mutations, according to a study published in the June 24 issue of the New England Journal of Medicine.
Makoto Maemondo, M.D., of the Miyagi Cancer Center in Japan, and colleagues randomly assigned 230 patients with metastatic NSCLC, who had EGFR mutations and had not received chemotherapy before, to treatment with either gefitinib or standard chemotherapy with carboplatin-paclitaxel. The patients were followed for progression-free survival, overall survival, response rates, and toxic side effects.
The researchers found the gefitinib group had twice the median progression-free survival as the standard-chemotherapy group (10.8 versus 5.4 months; P < 0.001), longer median overall survival (30.5 versus 23.6 months; P = 0.31), and a better response rate (73.7 versus 30.7 percent; P < 0.001). Rash was the most common adverse event in the gefitinib group (71.1 percent), followed by elevated aminotransferase levels (55.3 percent). One of the gefitinib patients died from interstitial lung disease.
"In conclusion, the efficacy of first-line gefitinib was superior to that of standard chemotherapy, with acceptable toxicity, in patients with advanced NSCLC harboring sensitive EGFR mutations. Selection of patients on the basis of EGFR-mutation status is strongly recommended," the authors write.