Journal Article

Gefitinib or Carboplatin–Paclitaxel in Pulmonary Adenocarcinoma

Wu, Yi-Long, Ohe, Yuichiro, Sunpaweravong, Patrapim, Han, Baohui, Mok, Tony S, Chewaskulyong, Busyamas, Nishiwaki, Yutaka, Thongprasert, Sumitra, Armour, Alison A, Saijo, Nagahiro, Margono, Benjamin, Yang, Jin-Ji, Chu, Da-Tong, Fukuoka, Masahiro, Ichinose, Yukito, Duffield, Emma L, Jiang, Haiyi, Yang, Chih-Hsin, Watkins, Claire L

2009

Overview

This trial compared gefitinib, an inhibitor of the tyrosine kinase of epidermal growth factor (EGFR), with carboplatin plus paclitaxel as initial treatment of pulmonary adenocarcinoma in more than 1200 East Asian patients. The primary end point, progression-free survival, was significantly longer with gefitinib therapy among patients whose tumors carried an EGFR mutation and with carboplatin plus paclitaxel therapy among patients with mutation-negative tumors. In East Asian patients with pulmonary adenocarcinoma, progression-free survival was significantly longer with gefitinib therapy among patients whose tumors carried an EGFR mutation and with carboplatin plus paclitaxel therapy among patients with mutation-negative tumors. Inhibitors of the epidermal growth factor receptor (EGFR) tyrosine kinase have clinical efficacy, as compared with the best supportive care 1 or standard chemotherapy, 2 when given as second-line or third-line therapy for advanced non–small-cell lung cancer. Treatment with EGFR tyrosine kinase inhibitors is most effective in women, patients who have never smoked, patients with pulmonary adenocarcinomas, and patients of Asian origin. In these populations, such treatment is associated with favorable rates of objective responses, progression-free survival, and overall survival. 1 , 3 , 4 These populations also have a relatively high incidence of somatic mutations in the region of the EGFR gene that encodes . . .

• Publisher: Massachusetts Medical Society
• Subject: Adenocarcinoma - drug therapy / Adenocarcinoma - genetics / Adenocarcinoma - mortality / Adult / Aged / Aged, 80 and over / Antineoplastic Agents - adverse effects / Antineoplastic Agents - therapeutic use / Antineoplastic Combined Chemotherapy Protocols - adverse effects / Antineoplastic Combined Chemotherapy Protocols - therapeutic use / Biological and medical sciences / Carboplatin - adverse effects / Carboplatin - therapeutic use / Carcinoma, Non-Small-Cell Lung - drug therapy / Chemotherapy / Disease-Free Survival / Female / General aspects / Humans / Kaplan-Meier Estimate / Lung cancer / Lung Neoplasms - drug therapy / Lung Neoplasms - genetics / Lung Neoplasms - mortality / Male / Medical sciences / Middle Aged / Mutation / Ovarian cancer / Paclitaxel - adverse effects / Paclitaxel - therapeutic use / Pharmaceutical industry / Proportional Hazards Models / Protein Kinase Inhibitors - therapeutic use / Quinazolines - adverse effects / Quinazolines - therapeutic use / Receptor, Epidermal Growth Factor - antagonists & inhibitors / Receptor, Epidermal Growth Factor - genetics