A comparative study on erlotinib & gefitinib therapy in non-small cell lung carcinoma patients
Preenumol Thomas1, Bini Vincent1, Christeena George1
1Department of Pharmacy Practice, Amrita School of Pharmacy, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, India.
Background & Objectives:
Tyrosine kinase inhibitors (TKIs) targeting the epidermal growth factor receptor (EGFR) have been evaluated in patients with advanced non-small cell lung cancer (NSCLC). Erlotinib and gefitinib are the first-generation EGFR-TKIs for patients with NSCLC. However, there is a paucity of studies comparing the effectiveness of these two drugs. Hence, this study was aimed to compare the effectiveness and safety of erlotinib and gefitinib in NSCLC patients.
Methods:
This study included 71 NSCLC patients who received EGFR-TKIs between 2013 and 2016. Adverse drug reaction of both erlotinib (n=37) and gefitinib (n=34) was determined and graded according to Common Terminology Criteria for Adverse Events grading system. Effectiveness was measured using response evaluation criteria in solid tumours and progression-free survival (PFS). Pharmacoeconomic analysis was performed by cost-effective analysis.
Results:
When comparing safety profile, both the drugs had similar adverse events except for dermal side effects such as acneiform eruption (51.4%), rash (54.05%) and mucositis (59.5%) for erlotinib and 20.6, 26.5 and 29.4 per cent for gefitinib, respectively. The PFS of the two drugs was compared to differentiate the effectiveness of erlotinib and gefitinib. There was no significant difference between the effectiveness of the two drugs. The pharmacoeconomic analysis showed that gefitinib was more cost-effective than erlotinib.
Interpretation & Conclusions:
This study showed that erlotinib and gefitinib had similar effectiveness but gefitinib had a better safety profile compared to erlotinib. Therefore, gefitinib could be considered a better option for NSCLC patients compared to erlotinib. However, further studies need to be done with a large sample to confirm these findings.
Insights
Gefitinib and erlotinib show similar effectiveness in non-small cell lung cancer (NSCLC) patients. Gefitinib offers a better safety profile and is more cost-effective, making it a preferred choice for NSCLC treatment.
Area of Science:
- Oncology
- Pharmacology
- Clinical Trials
Background:
- First-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) like erlotinib and gefitinib are used for advanced non-small cell lung cancer (NSCLC).
- Limited comparative studies exist on the effectiveness and safety of erlotinib versus gefitinib in NSCLC patients.
Purpose of the Study:
- To compare the effectiveness and safety of erlotinib and gefitinib in NSCLC patients.
- To conduct a pharmacoeconomic analysis of these two EGFR-TKIs.
Main Methods:
- A comparative study involving 71 NSCLC patients treated with erlotinib (n=37) or gefitinib (n=34) between 2013 and 2016.
- Adverse drug reactions were graded using Common Terminology Criteria for Adverse Events.
- Effectiveness was assessed by tumor response and progression-free survival (PFS).
- Cost-effectiveness analysis was performed.
Main Results:
- Both drugs exhibited similar effectiveness in terms of PFS.
- Gefitinib demonstrated a more favorable safety profile with significantly lower rates of dermal side effects (acneiform eruption, rash) and mucositis compared to erlotinib.
- Pharmacoeconomic analysis indicated that gefitinib was more cost-effective than erlotinib.
Conclusions:
- Erlotinib and gefitinib have comparable efficacy in NSCLC treatment.
- Gefitinib presents a superior safety profile and better cost-effectiveness, suggesting it as a potentially preferable option for NSCLC management.
- Further large-scale studies are warranted to validate these findings.
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