The targeted therapy gefitinib should be considered a first-line therapy for non-smoking Asian patients with adenocarcinoma of the lung suggests a presentation at the 33rd Congress of the European Society for Medical Oncology (ESMO) in Stockholm.

Asia has a high proportion of lung cancer patients who are non-smokers, a significant proportion of whom develop adenocarcinoma.

"Around 50% to 60% of this population have tumors with mutations in the epidermal growth factor receptor, and we know that patients with such mutations have a significantly better treatment outcome with gefitinib," said researcher Prof. Tony Mok from the Chinese University of Hong Kong.

"Currently, gefitinib and other EGFR tyrosine kinase inhibitors are considered as second line therapy for advanced non-small-cell lung cancers, meaning that the drugs should only be used after cancers fail to respond to the standard cytotoxic chemotherapy."

Prof. Mok's group studied 1,217 patients with advanced NSCLC (Stage IIIB/IV) who had never received chemotherapy and had never smoked or were light ex-smokers. They were randomized to receive gefitinib 250 mg/day (n = 609) or a combination of carboplatin and paclitaxel, 200 mg/m² (n = 608). The study was conducted in 7 Asian countries.

Over 22 months of follow-up, 453 (74.4%) patients in the gefitinib group experienced disease progression, compared to 497 (81.7%) patients in the combination arm (HR 0.74; 95% CI, 0.65-0.85; p<0.0001).

In addition, quality-of-life scores, as documented by the patient, were significantly higher in the gefitinib group than in the carboplatin/paclitaxel combination group (p=0.0148).

"We have demonstrated better treatment outcomes with gefitinib over standard chemotherapy as first-line therapy for this clinically selected population," Prof. Mok said. "Our study has established the role of gefitinib as one of the standard first-line therapies for a clinically selected group of non-/light smokers with adenocarcinoma.