Platinum-Based Doublet Chemo Remains Standard of Care after First-Line Gefitinib

Share this content:
Continuation of gefitinib after progression on first-line gefitinib did not improve survival in NSCLC.
Continuation of gefitinib after progression on first-line gefitinib did not improve survival in NSCLC.

Continuation of gefitinib after radiological disease progression on first-line gefitinib did not improve progression-free survival in patients with EGFR-mutation-positive non-small cell lung cancer (NSCLC) who received platinum-double based chemotherapy as subsequent line of treatment, a new study published in the journal The Lancet Oncology has shown.

For the multicenter, phase 3 IMPRESS trial, research sought to evaluate the safety and efficacy of continuing gefitinib, an EGFR tyrosine-kinase inhibitor, plus chemotherapy compared with chemotherapy alone in patients with EGFR-mutation-positive advanced NSCLC who acquired resistance to first-line treatment with gefitinib.

Researchers enrolled 265 patients with chemotherapy-naive, stage 3B-4 EGFR-mutation-positive NSCLC who previously responded to first-line gefitinib.

Patients were randomly assigned 1:1 to receive gefitinib 250 mg orally or placebo, in combination with cisplatin 75 mg/m2 IV plus pemetrexed 500 mg/m2 IV on day 1 of each cycle until disease progression or unacceptable toxicity.

Results showed that median progression-free survival was 5.4 months in both groups (95% CI: 4.5, 5.7 with gefitinib and 4.6, 5.5 with placebo). Researchers found that 74% of patients in the gefitinib group had experienced disease progression versus 81% of patients in the placebo group (HR = 0.86; 95% CI: 0.65, 1.13; P=0.27).

RELATED: Vorinostat May Improve Efficacy of Gefitinib in EGFR-Mutant Non-Small Cell Lung Cancer

In regard to safety, grade 3 or worse anemia and neutropenia were more common in the gefitinib group than the placebo group.

The findings suggest that platinum-based double chemotherapy should remain the standard of care for patients with EGFR-mutation-positive advanced NSCLC who have progressed after first-line treatment with gefitinib.

Related Resources

You must be a registered member of Cancer Therapy Advisor to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings


Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Prostate Cancer Regimens Drugs
Rare Cancers Regimens
Renal Cell Carcinoma Regimens Drugs
Skin Cancer Regimens Drugs
Urologic Cancers Regimens Drugs