Title: Role of Gefitinib as First Line Treatment in Patients with Advanced Adenocarcinoma Lung
Authors: Jyothi E, Suraj KP, Gayathri Mohan
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.199
Abstract
Introduction
Lung cancer is the most common cause of cancer related deaths worldwide1. Even with advances in chemotherapy and surgical therapy, the overall 5-year survival in lung cancer remains dismal at 12% to 16%2. At present lung cancer therapy is in the path of a revolution toward personalised therapy. In the past decade, multiple advances have been made in understanding the underlying biology and molecular mechanism of lung cancer, especially adenocarcinoma. With the arrival of targeted therapy there has been significantly improved outcome in metastatic lung malignancy.
There are 2 broad categories of lung cancer- Small Cell Lung Cancer (SCLC) and Non-Small Cell Lung Cancer (NSCLC). Non-small cell lung cancer consists mainly of adenocarcinoma (38.5%), squamous cell carcinoma (20%) and large cell carcinoma. In the past several decades adenocarcinoma has replaced squamous cell carcinoma as the most prevalent histopathological type.
References
1. CDC - Lung Cancer - Centers for Disease Control and Prevention https://www.cdc.gov/cancer/lung/index.htm( Accessed on 11-6-2017)
2. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics.,CA Cancer J Clin. 2011 Mar-Apr;61(2):69-90
3. Paez JG1, Jänne PA, Lee JC, Tracy S, Greulich H, Gabriel S, Herman P et al, EGFR mutations in lung cancer: correlation with clinical response to gefitinib therapy. Science. 2004 Jun 4;304(5676):1497-500.
4. Lecia V. Sequist, Daphne W. Bell, Thomas J. Lynch, and Daniel A. Haber Molecular Predictors of Response to Epidermal Growth Factor Receptor Antagonists in Non–Small-Cell Lung CancerJournal of Clinical Oncology200725:5, 587-595
5. Sequist LV, Martins RG, Spigel D, Grunberg SM, Spira A, Jänne PA, Joshi VA, McCollum D, Evans TL, Muzikansky A. : First-line gefitinib in patients with advanced non-small-cell lung cancerharboring somatic EGFRmutations. J ClinOncol. 2008 May 20;26(15):2442-9
6. Asahina H, Yamazaki K, Kinoshita I, Sukoh N, Harada M, Yokouchi H, Ishida T, A phase II trial of gefitinib as first-line therapy for advanced non-small cell lung cancer with epidermal growth factor receptor mutations. Br J Cancer. 2006 Oct 23;95(8):998-1004.
7. Sae-Won Han, Tae-You Kim, PilGyu Hwang, SoohyunJeong, Jeongmi Kim, In Sil Choi, Do-Youn Oh, ) Predictive and Prognostic Impact of Epidermal Growth Factor Receptor Mutation in Non–Small-Cell Lung Cancer Patients Treated With Gefitinib, Journal of Clinical Oncology 23, no. 11 (April 2005) 2493-2501.
8. , , , et al. Prospective phase II study of gefitinib for chemotherapy-naive patients with advanced non-small-cell lung cancer with epidermal growth factor receptor gene mutations. J ClinOncol2006;24:3340-334.
9. Rosell R, Moran T, Queralt C, et al. Screening for epidermal growth factor receptor mutations in lung cancer. N Engl J Med 2009;361.
10. Tony S. Mok, M.D., Yi-Long Wu, M.D., F.A.C.S., Sumitra Thongprasert, M.D., Chih-Hsin Yang, M.D., Ph.D., Da-Tong Chu, M.D., Gefitinib or Carboplatin–Paclitaxel in Pulmonary Adenocarcinoma N Engl J Med 2009; 361:947-9579
11. Hayashibara K1, Satoh H, Shinohara Y, Inagaki M, Kaburagi T, Hashimoto T, Kurishima K, Ishikawa H, Ichimura H, Nawa T, : A population-based study of gefitinib in patients with non-small cell lung cancer. Med Oncol. 2009;26(2):222-7 (median survival of 8 months
12. Toyooka S, Takano T, Kosaka T, Hotta KMatsuo KIchihara S Fujiwara Y Soh J Otani H Kiura K Aoe : Epidermal growth factor receptor mutation, but not sex and smoking, is independently associated with favorable prognosis of gefitinib-treated patients with lung adenocarcinoma, Cancer Sci. 2008 Feb;99(2):303-8 ( Smokers good response)
13. Masayuki Takeda , Kazuhiko Nakagawa Toxicity profile of epidermal growth factor receptor tyrosine kinase inhibitors in patients with epidermal growth factor receptor gene mutation-positive lung cancer, Mol Clin Oncol. 2017Jan;6(1):3–6.
Dr Suraj KP
Professor, Department of Pulmonary Medicine
Government Medical College, Kozhikode