Oral agent suitable for previously treated non-small-cell lung cancer

NEW YORK (Reuters Health) - New research indicates that gefitinib, an oral agent, is a suitable alternative to intravenous docetaxel for patients with previously treated non-small-cell lung cancer.

The median survival period achieved with each agent was roughly 8 months, according to the results of the Iressa NSCLC Trial Evaluating REsponse and Survival versus Taxotere (INTEREST) study.

"The clinical management of advanced non-small-cell lung cancer remains challenging, but an oral agent that has similar efficacy, has a more favorable tolerability profile, and results in better quality of life than intravenous chemotherapy is an important shift in the treatment paradigm for this disease and presents an alternative option for patients," Dr. Edward S. Kim and co-researchers conclude.

The phase III study, which is reported in the November 22nd issue of The Lancet, involved 1466 patients, previously treated with at least one platinum-based regimen, who were randomized to receive gefitinib 250 mg/day or docetaxel 75 mg/m� as a 1-hour infusion every 3 weeks.

Median survival in the gefitinib group was 7.6 months, not significantly different from the 8.0 months seen in the docetaxel group, Dr. Kim, from M. D. Anderson Cancer Center in Houston, and colleagues conclude.

Despite being an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, gefitinib was not superior to docetaxel in improving survival in patients with high EGFR-gene-copy number.

Rash or acne and diarrhea were the most common side effects with gefitinib, while neutropenia, asthenic disorders, and alopecia were dominant with docetaxel.

In a related editorial, Dr. Michael Cullen from University Hospital Birmingham, UK, and Dr. Nicholas Thatcher from Christie Hospital, Manchester, UK, comment that "from INTEREST, we now have more than one option to offer patients after first-line chemotherapy. While our understanding of predictive biomarkers develops, the choice of drug is likely to be influenced by patients' views and performance status as well as previous adverse effects."

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