title: Safety of gefitinib in non-small cell lung cancer treatment.
abstract: BACKGROUND
  The development of EGFR TKI and the subsequent identification of activating EGFR mutations have dramatically changed how NSCLC is treated. With its recent approval by the US Food and Drug Administration, gefitinib adds to the list of recommended first-line treatments for lung cancer harboring EGFR mutations, which hitherto includes erlotinib and afatinib.
  
  
  METHODS
  This review summarizes the pharmacological property, clinical efficacy, and safety of gefitinib in major clinical trials and post-marketing studies.
  
  
  CONCLUSIONS
  Gefitinib is a well-tolerated treatment for advanced NSCLC. The most common adverse events are skin reaction and diarrhea, both of which are generally mild, noncumulative, and manageable. Other side effects such as interstitial lung disease and liver toxicity are less common but can be serious. Which EGFR TKI is the preferred first-line treatment is a matter of debate. Gefitinib and erlotinib have comparable efficacy, whereas afatinib may exert superior clinical activity over gefitinib. In terms of the most common toxicities of skin reaction and diarrhea, gefitinib may be the most tolerable of the three. Hence, despite being the earliest EGFR TKI developed, gefitinib continues to be one of the first-line treatments for advanced EGFR-mutated NSCLC, especially when skin and gastrointestinal toxicity is a concern.
authors.affiliation: a Department of Oncology , National Taiwan University Hospital , Taipei , Taiwan.
authors.forename: Emily Han-Chung
authors.initials: EH
authors.lastname: Hsiue
authors.affiliation: a Department of Oncology , National Taiwan University Hospital , Taipei , Taiwan.|b Department of Medical Research , National Taiwan University Hospital , Taipei , Taiwan.|c Graduate Institute of Oncology , National Taiwan University College of Medicine , Taipei , Taiwan.|d National Taiwan University Cancer Center , Taipei , Taiwan.
authors.forename: Jih-Hsiang
authors.initials: JH
authors.lastname: Lee
authors.affiliation: a Department of Oncology , National Taiwan University Hospital , Taipei , Taiwan.|c Graduate Institute of Oncology , National Taiwan University College of Medicine , Taipei , Taiwan.|d National Taiwan University Cancer Center , Taipei , Taiwan.
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Lin
authors.affiliation: a Department of Oncology , National Taiwan University Hospital , Taipei , Taiwan.|b Department of Medical Research , National Taiwan University Hospital , Taipei , Taiwan.|c Graduate Institute of Oncology , National Taiwan University College of Medicine , Taipei , Taiwan.|d National Taiwan University Cancer Center , Taipei , Taiwan.
authors.forename: James Chih-Hsin
authors.initials: JC
authors.lastname: Yang
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D066246:ErbB Receptors / Q000235:genetics; D000077156:Gefitinib; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D009154:Mutation; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D011799:Quinazolines / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D011799:Quinazolines; D066246:ErbB Receptors; D000077156:Gefitinib
keywords: EGFR; gefitinib; non-small cell lung cancer; safety; tyrosine kinase inhibitor