This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Oncology  • Lung Cancer  • Pulmonary Diseases  • Pulmonary Diseases, Other  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 146 words of the full text and any section headings.

To the Editor: Dr Kris and colleagues¹ reported that gefitinib improved both symptoms and radiological responses in patients with non–small cell lung cancer who had previously undergone standard chemotherapy.

Although the authors reported that female sex and adenocarcinoma histology were predictive of favorable response to gefitinib, they apparently did not assess response to previous chemotherapy. It would be of interest to know if this is predictive of a positive outcome. For instance, Shepherd et al² reported that of 6 patients who responded to docetaxel, 3 had had a positive response to standard chemotherapy treatment and the other 3 had achieved stable disease; no patient who responded to docetaxel had progressed while receiving platinum-based chemotherapy.²

Other studies^3-4 found no benefit of adding gefitinib to standard chemotherapy as first-line treatment of advanced non–small cell lung cancer. Thus it is possible that both treatments target the same cell population.

Andrea Ardizzoni, MD
andrea.ardizzoni{at}istge.it

Marcello Tiseo, MD
Istituto Nazionale per la Ricerca sul Cancro
Genova, Italy

1. Kris MG, Natale RB, Herbst RS, et al. Efficacy of gefitinib, an inhibitor of the epidermal growth factor receptor tyrosine kinase, in symptomatic patients with non-small cell lung cancer. JAMA. 2003;290:2149-2158. FREE FULL TEXT 2. Shepherd FA, Dancey J, Ramlau R, et al. Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol. 2000;18:2095-2103. FREE FULL TEXT 3. Giaccone G, Johnson DH, Manegold C, et al. A phase III clinical trial of ZD1839 ("Iressa") in combination with gemcitabina and cisplatin in chemotherapy-naive patients with advanced non-small-cell lung cancer (INTACT1). Presented at: 27th European Society for Medical Oncology; October 18-22, 2002; Nice, France. Abstract 40. 4. Johnson DH, Herbst R, Giaccone G, et al. ZD1839 ("Iressa") in combination with paclitaxel and carboplatin in chemotherapy-naive patients with advanced non-small-cell lung cancer (NSCLC): results from a phase III clinical trial (INTACT2). Presented at: 27th European Society for Medical Oncology; October 18-22, 2002; Nice, France. Abstract 4680.

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2004;291:1563.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Predictors of Clinical Response of Non–Small Cell Cancer to Gefitinib—Reply
Mark G. Kris, Andrea C. Kay, Judith J. Ochs, and Michael K. Wolf
JAMA. 2004;291(13):1563-1564.
EXTRACT | FULL TEXT  

Efficacy of Gefitinib, an Inhibitor of the Epidermal Growth Factor Receptor Tyrosine Kinase, in Symptomatic Patients With Non–Small Cell Lung Cancer: A Randomized Trial
Mark G. Kris, Ronald B. Natale, Roy S. Herbst, Thomas J. Lynch, Jr, Diane Prager, Chandra P. Belani, Joan H. Schiller, Karen Kelly, Harris Spiridonidis, Alan Sandler, Kathy S. Albain, David Cella, Michael K. Wolf, Steven D. Averbuch, Judith J. Ochs, and Andrea C. Kay
JAMA. 2003;290(16):2149-2158.
ABSTRACT | FULL TEXT