Gefitinib or carboplatin–paclitaxel in pulmonary adenocarcinoma
Gefitinib is superior to carboplatin–paclitaxel as an initial treatment for pulmonary adenocarcinoma among nonsmokers or former light smokers in East Asia
Previous, uncontrolled studies have suggested that first-line treatment with gefitinib would be efficacious in selected patients with non–small-cell lung cancer. In phase 3, open-label study, Dr Tony S Mok of the Department of Clinical Oncology, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, HKSAR, China and colleagues from different East Asian sites randomly assigned previously untreated patients with advanced pulmonary adenocarcinoma and who were nonsmokers or former light smokers to receive gefitinib (250 mg per day) (609 patients) or carboplatin (at a dose calculated to produce an area under the curve of 5 or 6 mg per milliliter per minute) plus paclitaxel (200 mg per square meter of body-surface area) (608 patients). The primary end point was progression-free survival (PFS). The 12-month rates of PFS were 24.9% with gefitinib and 6.7% with carboplatin–paclitaxel. The study met its primary objective of showing the non-inferiority of gefitinib and also showed its superiority, as compared with carboplatin–paclitaxel, with respect to PFS in the intention-to-treat population (P <>
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