Gefitinib (ZD1839) monotherapy as a salvage regimen for previously treated advanced non-small cell lung cancer

Purpose: A worldwide compassionate-use program has enabled >42,000 patients with advanced non-small cell lung cancer (NSCL) to receive gefitinib treatment. Here we report the outcome of gefitinib therapy in patients who enrolled in the "Iressa" Expanded Access Program at the Samsung Medical Center. Experimental Design: Patients with advanced or metastatic NSCLC who had progressed after prior systemic chemotherapy and for whom no other treatment option was available were eligible to receive gefitinib treatment as part of the Expanded Access Program. A post hoe assessment of potential prognostic factors for response and survival was performed by multivariate analysis. Results: All 111 evaluable patients had stage IV disease; most patients had a baseline performance status of 2 [n = 52 (47%)] or 3 [n = 18 (16%)] and had received greater than or equal to2 prior chemotherapy regimens (56%). The objective response rate was 26%, the disease control rate (measured over greater than or equal to8 weeks) was 40%, and the 1-year survival rate was 44%. Adenocarcinoma histology was associated with better response and disease control rates, and a Performance status of 0-2 was also associated with a better disease control rate. Both of these factors, as well as female gender, were significantly associated with longer survival. Gefitinib was well tolerated; the most common adverse event was grade 1 skin rash. Conclusions: Gefitinib demonstrated significant antitumor activity and a favorable tolerability profile in this series of NSCLC patients with poor prognosis.