J Lung Cancer.  2009 Dec;8(2):61-66. 10.6058/jlc.2009.8.2.61.

Comparison of Gefitinib versus Docetaxel in Patients with Pre-Treated Non-Small Cell Lung Cancer (NSCLC)

• Hirsh V

• KMID: 2199965
• DOI: http://doi.org/10.6058/jlc.2009.8.2.61

Abstract

More effective treatments in first, second, and third-line of metastatic non-small cell lung cancer (NSCLC) enable patients to live longer, with a better quality of life (QOL). Especially epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) contributed to this improvement. Gefitinib was compared with Docetaxel in four randomized trials, i.e., SIGN, Japanese V-1532, Korean ISTANA, and INTEREST in second or third-line treatment of metastatic NSCLC. In all the trials, and also by meta-analysis of 2,257 patients in these trials, Gefitinib was found non-inferior or superior to Docetaxel, with less toxicity, convenient oral administration, and better QOL. Detailed results are presented in the review article. Knowing that every line of treatment we may lose about 50% of patients for further treatment, it is very important to offer each patient the best option for every line of treatment. Gefitinib has a favorable benefit-risk profile compared with Docetaxel in this patient population.

Keyword

Gefitinib; Docetaxel; 2nd line treatment; 3rd line treatment; Non-small cell lung carcinoma; Metastatic

MeSH Terms

Administration, Oral
Asian Continental Ancestry Group
Carcinoma, Non-Small-Cell Lung
Humans
Oligosaccharides
Protein-Tyrosine Kinases
Quality of Life
Quinazolines
Receptor, Epidermal Growth Factor
Taxoids
Oligosaccharides
Protein-Tyrosine Kinases
Quinazolines
Receptor, Epidermal Growth Factor
Taxoids

Figure

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  Fig. 1. SIGN: quality of life (QOL) & symptom improvement, LCS: lung cancer subscale, FACT-L: functional assessment of cancer therapy-lung, CI: confidence interval.

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  Fig. 2. Quality of life and symptom improvement rates (EFQ population) – INTEREST. p values from logistic regression with covariates. Clinically relevant improvement pre-defined as 6-point improvement for FACT-L and TOI; 2-point improvement for LCS, maintained for at least 21 days. EFQ: evaluable for quality of life, FACT-L: functional assessment of cancer therapy-lung, TOI: trial outcome index, LCS: lung cancer subscale.

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  Fig. 3. Kaplan-Meier curves of (A) overall survival and (B) progression-free survival for all patients (Meta-analysis).

Reference

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