Gefitinib for advanced non-small-cell lung cancer and quality of life: expanding and improving treatment options

Abstract

Patients with advanced non-small-cell lung cancer (NSCLC) who fail first-line chemotherapy have a poor prognosis and, up until the beginning of this decade, were left with limited treatment options. In 2000, Shepherd et al. [1] published the results of a pivotal randomized phase III trial that established the role of second-line chemotherapy in the treatment of this disease—docetaxel (75 or 100 mg/m² every 21 days) increased median overall survival (OS) from 4.6 to 7.0 months when compared with best supportive care (P = 0.010). The dose of 75 mg/m² was better tolerated and, following presentation of these data, became widely accepted as the new standard of care for platinum-treated patients with a performance status (PS) of zero to two (P = 0.010). Many clinicians and patients would argue, however, that in light of such small improvement in survival, quality-of-life (QoL) analysis would be crucial to ascertain the true benefits of and justify the use of chemotherapy in this setting.