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Vol.45 No.7 contents | Japanese/English |
 | Full Text of PDF (94K) Article in Japanese |
- Review -
New Chemotherapeutic Agents -Molecular Targeted Therapy for NSCLC-
Koji Takeda11Department of Clinical Oncology, Osaka City General Hospital, Japan
Gefitinib (Iressa®) and erlotinib (Tarceva®), which are epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI), have been used in treatment for patients with advanced non-small cell lung cancer (NSCLC). Several clinical trials have revealed important findings in the clinical therapeutic mechanism of EGFR-TKI. In Japan, gefitinib was approved by the Japanese Ministry of Health, Labour and Welfare, for the first time in the world, in July 2002. A large number of patients with NSCLC have received gefitinib. High incidence and mortality due to interstitial lung disease (ILD) induced by gefitinib gave rise to public criticism of the early approval. A randomized phase III trial (BR21) of erlotinib compared with placebo in NSCLC patients with previous chemotherapy showed that erlotinib had a significant survival advantage. Various predictive factors of EGFR-TKIs were revealed by several clinical trials such as female gender, adenocarcinoma, non-smoker, Japanese ethnicity. It is very exciting that EGFR gene mutations are related with response to EGFR-TKIs. This finding is expected to open the door to individualized treatment. Preclinical and clinical studies of molecular targeted therapy are making rapid progress. Recently, a randomized controlled trial of gefitinib compared with placebo in second-line treatment for NSCLC failed to show a significant survival advantage of gefitinib. EGFR mutations were indicated to be reliable predictive factors of response and survival in patients with NSCLC.
key words: Erlotinib, Gefitinib, Epidermal growth factor receptor (EGFR), Non-small cell lung cancer (NSCLC), Molecular targeted therapy
JJLC 45 (7): 793-799, 2005
