Posted on February 19th, 2010 by
Patients with non–small cell lung cancer (NSCLC) who have a mutation of the epidermal growth factor receptor (EGFR) experienced a better progression-free survival when treated with Iressa® (gefitinib) rather than the standard doublet therapy consisting of Platinol® (cisplatin) and Taxotere® (docetaxel). The results of this study were published in the Lancet Oncology.
Non–small cell lung cancer (NSCLC) accounts for roughly 85% of all lung cancers; non–small cell refers to the type of cell within the lung where the cancer originated. In advanced NSCLC cancer has spread outside the lung; standard therapy for this stage of disease includes chemotherapy. However, chemotherapy is often difficult to tolerate. Another approach to treatment utilizes agents targeted specifically against cancer cells; these targeted agents may have fewer side effects.
Iressa is an oral agent that is targeted specifically against the human epidermal growth factor receptor (EGFR). EGFR is a protein that is found on the surface of cells and is involved in cellular growth, spread, and replication. Cancerous cells often overexpress EGFR or have mutations within EGFR, leading to uncontrolled growth or spread of the cancer cells. Iressa binds to EGFR and halts or reduces its effects on cancer cells.
Researchers with the West Japan Oncology Group conducted a Phase III trial that included 172 patients under age 75 with Stage IIIB or IV NSCLC harboring EGFR mutations. No patients had previously undergone chemotherapy. The patients were randomly assigned to receive Iressa or Platinol/Taxotere. The primary endpoint of the study was progression-free survival.
The group of patients receiving Iressa experienced a significantly longer period of progression-free survival (9.2 months) compared with the Platinol/Taxotere group (6.3 months). Toxicity was tolerable for both groups; grade 3/4 adverse events were rare.
The researchers concluded that patients with NSCLC with EGFR mutations have a longer progression-free survival if treated with Iressa rather than Platinol/Taxotere.
Reference: Mitsudomi T, Morita S, Yatabe Y, et al. Gefitinib versus cisplatin plus docetaxel in patients with non-small cell lung cancer harbouring mutations of the epidermal growth factor receptor (WJTOG3405): An open-label, randomized phase 3 trial. Lancet Oncology. 2010; 11: 121-128.
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