Is gefitinib beneficial when combined with chemotherapy in the treatment of non-small cell lung cancer?

This article looked at the effectiveness of gefitinib (Iressa) combined with chemotherapy when compared to a chemotherapy aline in the treatment of non-small cell lung cancer (NSCLC). The authors found that the addition of gefitinib to a chemotherapy increased the progression-free survival (PFS) of these patients. 

NSCLC is a form of lung cancer. It is responsible for about 85% of lung cancer cases worldwide. Lung cancer has one of the highest mortality rates worldwide. Standard treatment for NSCLC is the surgical removal of the tumor, chemotherapy, and radiation therapy. However, in advanced cases, other treatments such as targeted therapy drugs can improve prognosis.

Gefitinib is a targeted therapy drug. It is an EGFR inhibitor. EGFR is a protein responsible for processes within cells. It can be increased in some forms of cancer including NSCLC. Previous studies have indicated that EGFR inhibitors could be useful in slowing the spread of cancer. However, the evidence regarding the benefit of gefitinib in the treatment of NSCLC is controversial. It is important to determine the effectiveness and safety of gefitinib and chemotherapy compared to a chemotherapy alone in patients with advanced NSCLC. 

The study looked at 7 trials that were carried out with a total of 1418 patients with NSCLC. Patients were treated with either gefitinib and chemotherapy or with chemotherapy alone.

Overall, there was a 40% increase in PFS in the gefitinib group when compared to the chemotherapy-only group. The most benefit in PFS was seen with gefitinib therapy following chemotherapy (by 33%).

There was no significant improvement in overall survival in the gefitinib group when compared to the chemotherapy-alone group. There was also no significant improvement in the overall response rate between both groups. 

The risks of patients developing side effects were similar between the 2 groups. The gefitinib group had a higher occurrence of diarrhea (2.83 times higher) and rash (3.82 times higher) when compared to the chemotherapy-only group. 

The authors found that the addition of gefitinib to a chemotherapy regimen resulted in a significantly increased PFS when compared to a chemotherapy-only regimen for the treatment of NSCLC. 

The studies evaluated were very different. They included various types of NSCLC and the types of chemotherapy and doses of gefitinib were different. Further studies are needed to establish the role of gefitinib in the treatment of NSCLC.