Treatment > ZD1839 (Iressa)

Abstract

Extensive experience of disease control with gefitinib and the role of prognostic markers

H Cortes-Funes¹ and H Soto Parra<sup>2

1</sup>Medical Oncology Service, Hospital Universitario 12 de Octubre, Avda Córdoba Km 5,4, Madrid 28041, Spain; ²Istituto Clinico Humanitas, Rozzano 20089, Italy. Correspondence to: H Cortes-Funes, E-mail: hcortes.hdoc@salud.madrid.org.

Traditionally, the efficacy of an anticancer agent has been measured by response rate. 
With the development of biological molecular-targeted agents, which have a different mechanism of action from conventional agents, it may be appropriate to consider alternative criteria that reflect the positive effect of these biological agents on disease control, palliation, symptom improvement and quality of life. 
One such targeted agent is the orally active epidermal growth factor receptor tyrosine kinase inhibitor gefitinib ('Iressa', ZD1839). 
This article reviews the clinical experience of patients with advanced/metastatic non-small-cell lung cancer, who have received gefitinib as part of a clinical trial or through the 'Iressa' Expanded Access Programme. 
Disease-control rates of ~50% were observed in some Expanded Access Programme series, comparable with results obtained from Phase II trials. 
Symptom improvement was also reported. 
Information that will help identify those patients most likely to respond to treatment will become increasingly important. 
Therefore, the possible role of prognostic markers and the relationship between epidermal growth factor receptor status and response to gefitinib has been investigated. 
No clear association between epidermal growth factor receptor expression and response was observed. 
Future studies of other biomarkers in the epidermal growth factor receptor pathway should help to identify which patients are likely to benefit most from gefitinib.

Keywords: gefitinib ('Iressa', ZD1839); EGFR; clinical benefit; disease control; prognostic marker

doi:10.1038/sj.bjc.6601476
© 2003 Cancer Research UK