Gefitinib treatment for non-small cell lung cancer -- a study including patients with poor performance status

Gefitinib is effective in the treatment of advanced non-small cell lung cancer (NSCLC). However, most studies have only investigated patients who have good performance status or are evaluable. This study evaluated the efficacy of geftinib in a consecutive series of patients with NSCLC.

The treatment response of all gefitinib-treated NSCLC patients from November 2001 to September 2003 at a single medical institute was retrospectively evaluated. All patients receiving at least 1 dose of gefitinib during the study period were included.

A total of 66 NSCLC patients were treated, including 22 patients with Eastern Clinical Oncology Group performance status 3 or 4. No prior chemotherapy had been given in 14 patients because of their personal preference or poor general condition. The duration of treatment ranged from 1 day to 19.3 months (median, 2.5 months). The partial remission rate was 15.2% and the stable disease rate was 25.8%. The median survival for all patients was 5.9 months and the 1-year survival rate was 27.9%. Symptom improvement and response correlated well to survival. Female gender, non-smoking status, and performance status of 0-2 were associated with better survival. The disease control rate was 22.7% in patients with performance status of 3-4.

Gefitinib can be recommended for the treatment of advanced NSCLC in patients for whom standard chemotherapy is not an option. Further study is required to determine the optimal selection criteria of patients and the timing of starting therapy.