Gefitinib effective in older, African American patients with non-small cell lung cancer (NSCLC)

Researchers have found that an FDA-approved therapy could be effective in treating both older and African American patients with advanced lung cancer who may not be candidates for chemotherapy, according to a phase 2 trial. The findings were published in Clinical Medicine Insights: Oncology (2014;8:121-128).

Gefitinib, a drug that targets and interrupts signaling through the epidermal growth factor receptor and is used to control the progression of cancer, could help patients with non-small cell lung cancer (NSCLC), which has few treatment options, said Nagla Karim, MD, PhD, associate professor in the Division of Hematology Oncology at the University of Cincinnati (UC) College of Medicine and member of the Cincinnati Cancer Center and the UC Cancer Institute in Ohio.

NSCLC is any type of lung cancer other than small-cell lung cancer, and it is the most common type of lung cancer.

"The epidermal growth factor receptor has been found in higher quantities in a variety of solid tumors, including non-small cell lung cancer,” said Karim, who is also a UC Health physician and principal investigator on this study. "Gefitinib is a safe oral agent that may be of benefit to a specific population of these patients.

"Improving the quality of life for patients with this type of lung cancer is an important goal as there is currently no beneficial treatment for them, and chemotherapy is often not an option because of their poor health status.”

In this study, researchers evaluated 12 patients who had advanced NSCLC with a poor prognosis but who had not undergone chemotherapy. Response rate, progression-free survival, overall survival, and quality of life were evaluated using the Functional Assessment of Cancer-Lung questionnaire and Trial Outcome Index.

The average age of the patients evaluated was 69 years, and the average duration of treatment was approximately 62 days.

Using the index to compare information collected from the questionnaire, the average overall survival for the population evaluated was almost 5 months, the progression-free survival was about 3 months, and quality of life and outcomes scores were higher in African Americans compared with whites as well as in older patients.

"Gefitinib is an overall active and well-tolerated therapy for this subgroup of patients with a poor prognosis and was found to improve quality of life,” Karim said. "In spite of the small number of patients in the study, our results suggest that older patients and those who were African Americans had higher quality of life scores and felt this treatment improved their outcomes. This study may provide evidence that gefitinib could be an option for therapy in this subgroup of patients for which chemotherapy is not recommended.”

This study was funded in part by AstraZeneca, which markets gefitinib under the trade name Iressa. Karim cites no conflict of interest.

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