Gefitinib: an “orphan” drug for non-small cell lung cancer

Pre-clinical drug-drug interactions (DDIs) of gefitinib with/without losartan and selective serotonin reuptake inhibitors (SSRIs): citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, and venlafaxine

Objective

Methods

Results

Conclusion

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In vitro hepatocytes assays can predict relevant drug-drug interactions (DDIs).

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Proof-of concept data testing can provide a clear insight of multidrug regimen DDIs.

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Classifying drugs as inhibitors/inducers alone cannot successfully identify DDIs.

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Regimens requiring three or more drugs may cause significant DDIs (p-value < 0.05).

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SSRI metabolism by human hepatocytes can be affected by gefitinib and losartan.

Characteristics and outcomes of patients with EGFR-mutation positive non-small-cell lung cancer receiving gefitinib beyond radiological progression

BACKGROUND

This study aimed to analyze the characteristics and outcomes of patients suffering from non-small-cell lung cancer (NSCLC) with epidermal growth factor receptor mutations (EGFRm+) receiving gefitinib who remained clinically stable following confirmation of progressive disease (PD) using Response Evaluation Criteria in Solid Tumors (RECIST) (R-PD) and identify those who benefited from tyrosine kinase inhibitor therapy beyond PD.

RESEARCH DESIGN AND METHODS

The clinical courses of patients with EGFRm+ advanced NSCLC who received first-line gefitinib were investigated. Clinical PD (C-PD) was defined as one or more of the following: (1) symptomatic PD, (2) worsening performance status resulting from PD, (3) threat to a major organ(s), or (4) unequivocal multiorgan PD.

RESULTS

Of 529 patients, 258 experienced R-PD without C-PD. Among 258 patients, 91 received gefitinib beyond R-PD. Females were more likely to receive gefitinib beyond R-PD and exhibit a longer time from R-PD to C-PD than males (median days, 175 vs. 79.5). Survival beyond R-PD tended to be longer for elderly patients who received gefitinib beyond PD than for those who did not (median days, 458 vs. 336), but this was not the case for non-elderly patients (median days, 481 vs. 487).

CONCLUSIONS

Some patients may benefit from continuation of gefitinib beyond PD.