Long-term outcomes of gefitinib compared to chemotherapy in patients with non-small cell lung cancer

This trial looked at the long-term effectiveness of gefitinib (Iressa) compared to vinorelbine (Navelbine) plus cisplatin (Platinol) for stage II-IIIA EGFR-positive non-small cell lung cancer (NSCLC). The authors found that the use of gefitinib improved disease-free survival (DFS) in these patients. 

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, leading to cancer growth and spread. Vinorelbine and cisplatin (VP) are chemotherapy drugs used in the treatment of NSCLC. Previous trials have not indicated the long-term effectiveness of gefitinib compared to VP chemotherapy in the treatment of early-stage NSCLC. 

There were 222 patients involved in this trial. 111 patients were randomly assigned to receive gefitinib and 111 were given VP. The average follow-up was 80 months. 

The average survival (OS) of patients taking gefitinib was 75.5 months. This was compared to 62.8 months in the VP group. This difference was not considered statistically significant. The 5 year OS rate was 53.2% in the gefitinib group and 51.2% in the VP group. 

The average disease-free survival (DFS) was significantly longer with gefitinib (30.8 months) compared to VP (19.8 months).

The authors found that in patients with early-stage NSCLC and EGFR-positive NSCLC, the use of gefitinib improved DFS compared to standard VP chemotherapy. 

Patients were only recruited from a Chinese population, this may not translate well to a worldwide population. Further studies need to be carried out on larger populations. This study was funded by AstraZeneca, the manufacturer of gefitinib.