Gefitinib therapy for advanced non-small-cell lung cancer.

OBJECTIVE

To review the pharmacology, pharmacokinetics, clinical efficacy, and toxicity of gefitinib in non-small-cell lung cancer (NSCLC).

DATA SOURCES

Primary literature search through MEDLINE and CANCERLIT, and abstract presentations (1966-May 2003).

STUDY SELECTION AND DATA EXTRACTION

All published trials and abstracts citing gefitinib were evaluated, and all information deemed relevant was included in this article.

DATA SYNTHESIS

NSCLC is known to overexpress epidermal growth factor receptor (EGFR). Gefitinib is a selective EGFR tyrosine kinase inhibitor. Based on the Phase I/II trial results, the optimal dose is 250 mg/d orally. It is well tolerated, with minimal and reversible toxicity. Skin rash and diarrhea are the most common adverse effects. Recent trials have shown that gefitinib provided a 10% tumor response rate and improved disease-related symptoms in patients with refractory, advanced NSCLC.

CONCLUSIONS

Gefitinib, with a unique mechanism of action and favorable toxicity profile, has demonstrated clinical activity in NSCLC patients with chemotherapy-refractory disease. It provides a valuable addition to the treatment options as monotherapy in patients with advanced NSCLC after failure of both platinum-based and docetaxel chemotherapies. Further research is required to evaluate the use of gefitinib in different clinical settings.