- Lung Cancer Chemotherapy
Lung Cancer Chemotherapy
Among patients with advanced non-small cell lung cancer without a mutation of a certain gene (EGFR), conventional chemotherapy, compared with treatment using epidermal growth factor receptor tyrosine kinase inhibitors, was associated with improvement in survival without progression of the cancer, but not with overall survival, according to a study in the April 9 issue of JAMA.
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are the preferred treatment option for patients with advanced non-small cell lung cancer (NSCLC) who have mutations in the EGFR gene. These drug-sensitive mutations are found in about 10 percent of Western patients and almost 50 percent of Asian patients with NSCLC.
However, a majority of patients with advanced NSCLC worldwide do not have tumors with these mutations (known as wild-type [WT]; no mutation detected within the gene). Studies have shown that TKI treatment is better than conventional chemotherapy in terms of progression-free survival (PFS) among patients with these EGFR mutations; it is not clear that EGFR TKIs are as effective as standard chemotherapy in patients without EGFR mutations, according to background information in the article
June-Koo Lee, M.D., of Seoul National University Hospital, Seoul, Republic of Korea, and colleagues performed a meta-analysis of randomized controlled trials that compared first-generation EGFR TKI (erlotinib and gefitinib) treatment with conventional chemotherapy in patients with advanced NSCLC without mutation of the EGFR gene. The authors identified 11 randomized controlled trials, with 1,605 patients with WT EGFR, which met criteria for inclusion in the meta-analysis.
The results indicated that chemotherapy was associated with longer PFS compared with EGFR TKI in patients with WT tumors. For a median (midpoint) PFS of 6.4 months in patients treated with standard chemotherapy, the corresponding reduction of PFS in patient receiving EGFR TKI would be 1.9 months.
The objective response rate (defined as the proportion of complete response and partial responses among all evaluable patients) was also higher with chemotherapy (92/549, 16.8 percent) compared with TKI (39/540, 7.2 percent). However, the overall survival did not differ between the two groups.
“… this study suggests that, in patients with WT EGFR tumors, conventional chemotherapy could be a preferable treatment option over EGFR TKI, although this recommendation cannot be conclusive because the overall comparisons were not based on randomization. Furthermore, the toxicity outcome was not assessed,” the authors write.
DISCLAIMER: Bankix Systems Ltd is the registered name of a Canadian firm since 2003, and bankixsystems.com is its OFFICIAL website. Besides these entities, we have no relationship with anyone, business, website, or any other entity anywhere in the world, claiming to be Bankix Systems, or using a similar name, and creating the impression that it has some connection with our company. We do not endorse and are therefore, not responsible for any act or lack thereof by any such entity. Bankix Systems Ltd is also not responsible for the content of the description of products and services linked to our site nor does it necessarily endorse them. The information here provided is not for diagnosing/treating your health concerns. Kindly contact your doctor or health care professional for all your healthcare requirements.
Contents © 2003-2019, BankixSystems.com. All rights reserved. Unauthorized reproduction strictly prohibited. Information based on best available resources. Opinions are current and subject to change.