Tuberc Respir Dis > Volume 57(2); 2004 > Article
Tuberculosis and Respiratory Diseases 2004;57(2):160-167.
DOI: https://doi.org/10.4046/trd.2004.57.2.160    Published online August 1, 2004.
The Efficacy of ZD1839 (Iressa(TM)) in Patients with Advanced Non- small Cell Lung Cancer which has Progressed After Previous Chemotherapy.
Seung Whan Lee, Duck Ryung Kim, Sang Dae Lee, Jong Sin Lee, Yeon Hee Park, Baek Yeol Ryoo, Heung Tae Kim, Sunhoo Park, Bong Seog Kim, Cheol Hyeon Kim, Jae Cheol Lee
1Department of Internal Medicine, Korea Cancer Center Hospital, Korea. cheol@kcch.re.kr
2Department of pathology, Korea Cancer Center Hospital, Korea.
3Department of Internal Medicine, Seoul Veterans Hospital, Korea.
Abstract
BACKGROUND
The role of second-line chemotherapy in the treatment of advanced non-small cell lung cancer (NSCLC) is known to be limited. Recently, ZD1839, the small molecule epidermal growth factor receptor-tyrosine kinase inhibitor, has been developed and has shown anti-tumor activity in patients with solid malignant tumors including lung cancer. We evaluated the response rate and toxicities of ZD1839 in patients with advanced NSCLC which has progressed after previous chemotherapy. PATIENTS AND METHODS: We examined 83 patients with advanced NSCLC treated with ZD1839 for more than 1 month in Korea Cancer Center Hospital during the period from January 2002 to September 2003. All the patients were enrolled in the international expanded access program (EAP) with ZD1839 by AstraZeneca. The administered dose of ZD1839 was 250 mg once daily. Chest radiography and laboratory tests were followed-up. We evaluated the response rate, median survival, and toxicity after treatment. RESULTS: Median age of the patients was 59 years (range 33-76). The most predominant cell type was adenocarcinoma and the most stage of the patients was IV. ECOG performance status was as follows; grade 0-1 in 10, grade 2 in 42, and grade 3 in 31 patients. Partial response was achieved in 12 patients (14.5%). Median overall survival was 9.2 (range 1.3-21.6+) months and median time to progression was 3.1 (range 1-21.2+) months. The most common adverse effect of ZD1839 was skin eruption which developed in 25 patients (25.8%). Significantly higher response rate and survival was found in patients with adenocarcinoma or good performance status. CONCLUSION: ZD1839 showed modest activity and tolerable toxicity in the treatment for patients with NSCLC which has progressed after previous chemotherapy.
Key Words: ZD1839, Non-small cell lung cancer, Epidermal growth factor receptor (EGFR)


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