Lessons from the 'Iressa' Expanded Access Programme: gefitinib in special non-small-cell lung cancer patient populations

被引:20
作者
Stahel, R
Rossi, A
Petruzelka, L
Kosimidis, P
de Braud, F
Bernardo, MM
Souquet, PJ
Parra, HS
Gridelli, C
机构
[1] Univ Spital Zurich, Klin & Poliklin Oncol, CH-8091 Zurich, Switzerland
[2] SG Moscati Hosp, Avellino, Italy
[3] Charles Univ Prague, Univ Hosp, Prague, Czech Republic
[4] An Tsoha & Vas Sofia Aven, Athens, Greece
[5] Ist Europeo Oncol, Milan, Italy
[6] Hosp Sta Antonio Dos Capuchos, Lisbon, Portugal
[7] Ist Clin Humanitas, Milan, Italy
[8] Ctr Hosp Lyon Sud, F-69310 Pierre Benite, France
关键词
gefitinib; ('Iressa'; ZD1839); EGFR-TKI; NSCLC; elderly; performance status; chemonaive;
D O I
10.1038/sj.bjc.6601479
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Some subgroups of patients with advanced/metastatic non-small-cell lung cancer (NSCLC) are frequently considered ineligible for the aggressive, platinum-based combination chemotherapy that is the recommended treatment. Elderly patients may have a poorer tolerance of chemotherapy due to impaired organ function and frequent comorbidities; patients with poor performance status (PS; greater than or equal to2 due to NSCLC and/or coexisting illnesses) are often considered unfit for chemotherapy; other patients may be unable or unwilling to endure the toxicity or inconvenience of chemotherapy. These patient groups may benefit from novel, relatively nontoxic treatment modalities. Gefitinib (Iressa, ZD1839) 250 mg day(-1) is well tolerated and has proven antitumour and symptom improvement activity in patients with previously treated NSCLC. Phase II trials (IDEAL 1 and 2) of gefitinib in advanced/metastatic NSCLC included 70 out of 425 (16.5%) patients with PS greater than or equal to2, and their response rate, clinical benefit rate and rates of adverse events were similar to those of the overall trial population. In addition, many patients with advanced/metastatic NSCLC with poor PS or advanced age have received gefitinib 250 mg day(-1) in an Expanded Access Programme (EAP). Observations from the EAP support those of IDEAL 1 and 2, and indicate that gefitinib 250 mg day(-1) warrants further investigation in these patient groups.
引用
收藏
页码:S19 / S23
页数:5
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