Chemotherapy can affect lung cancer response to gefitinib

NEW YORK (Reuters Health) - Chemotherapy-naive patients with non-small cell lung cancer (NSCLC) along with epidermal growth factor receptor mutations of the tyrosine kinase domain have greater responses to gefitinib than those who have received chemotherapy, according to Taiwanese researchers.

Nevertheless, the "overall survival of lung cancer patients with gefitinib-sensitive epidermal growth factor receptor mutations was not different whether gefitinib was used as first-line therapy or after chemotherapy," investigator Dr. Jin-Yuan Shih told Reuters Health

Dr. Shih of Taiwan University Hospital, Taipei and colleagues studied data from 152 NSCLC patients with deletions in exon 19 or L858R in exon 21 who were receiving gefitinib. The findings are published in the October 15th issue of the American Journal of Respiratory and Critical Care Medicine.

Of this group, 61 had received chemotherapy and the remaining 91 had not. About 76% of the chemotherapy-naive group responded compared to 54% of the chemotherapy-treated group. However, corresponding median survival (16.9 and 14.7 months) was not significantly different.

Being female was also significantly associated with response to gefitinib.

However, neither overall survival after the start of antitumor therapy nor progression-free survival after gefitinib therapy was significantly different between groups. "Clinical response to gefitinib," the investigators conclude, "was the only factor associated with better overall survival."

Commenting on the findings in an accompanying editorial, Dr. Pasi A. Janne of the Dana-Farber Institute in Boston points out that it would be of interest to determine whether response to gefitinib "decreased with an increasing number of prior chemotherapy treatments."

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