title: Treatment of non-small cell lung cancer with gefitinib ('Iressa', ZD1839): the Greek experience with a compassionate-use program.
abstract: This is a retrospective analysis of 150 patients with advanced non-small cell lung cancer who had failed prior treatment or were unfit for chemotherapy and were treated with oral gefitinib ('Iressa', ZD1839; AstraZeneca) 250 mg/day. Thirty-two patients who received gefitinib for 3 weeks or less were not included in the analysis. For the remaining 118 evaluable patients, the mean age was 63.1 years; most patients had received prior chemotherapy (97.5%), Eastern Cooperative Oncology Group performance status scores 0-2 (97.4%) and stage IV disease (64.4%). The majority were symptomatic (84.6%). Disease control was observed in 30 patients (25.4%), of whom five had a partial response and 25 had stable disease; 18 (15.3%) were not evaluable. Median duration of treatment was 29.9 weeks in responding patients and 11.5 in patients with progressive disease (p<0.0001). Median overall survival was 7.3 months (15.2 months for disease control) and median progression-free survival was 3.2 months. Gefitinib was well tolerated, with grade 3/4 skin rash and diarrhea seen in 2.5 and 4.2% of patients, respectively. Clinical benefit was evaluated using questionnaires before and following treatment with gefitinib. In 82 patients with completed questionnaires, evaluation revealed symptom improvement in 40.1% and improvement in general feeling in 31.4%. Epidermal growth factor receptor (EGFR) analysis found that efficacy did not correlate with tumor EGFR overexpression. Therefore, in this retrospective analysis, gefitinib treatment provided disease control in 25% of patients who derived significant palliative benefit.
authors.affiliation: HYGEIA Medical Center, Athens, Greece. edrazis@hol.gr
authors.forename: E
authors.initials: E
authors.lastname: Razis
authors.forename: D
authors.initials: D
authors.lastname: Skarlos
authors.forename: E
authors.initials: E
authors.lastname: Briasoulis
authors.forename: M
authors.initials: M
authors.lastname: Dimopoulos
authors.forename: G
authors.initials: G
authors.lastname: Fountzilas
authors.forename: S
authors.initials: S
authors.lastname: Lambropoulos
authors.forename: S
authors.initials: S
authors.lastname: Rigatos
authors.forename: P
authors.initials: P
authors.lastname: Kopterides
authors.forename: H
authors.initials: H
authors.lastname: Efstathiou
authors.forename: E
authors.initials: E
authors.lastname: Tzamakou
authors.forename: C
authors.initials: C
authors.lastname: Bakoyannis
authors.forename: D
authors.initials: D
authors.lastname: Pectasides
authors.forename: T
authors.initials: T
authors.lastname: Makatsoris
authors.forename: G
authors.initials: G
authors.lastname: Varthalitis
authors.forename: S
authors.initials: S
authors.lastname: Papadopoulos
authors.forename: P
authors.initials: P
authors.lastname: Kosmidis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D066246:ErbB Receptors / Q000037:antagonists & inhibitors; D005260:Female; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib