Gefitinib: Current status in the treatment of non-small cell lungcancer
Bibliographic record
Abstract
Gefitinib (Iressa) is a novel drug approved in 28 countries (as of June 2004), including Japan, the US, Canada and Australia as second- and third-line monotherapy for the treatment of locally advanced or metastatic non-small cell lung cancer refractory to prior chemotherapy. Gefitinib is an orally active, epidermal growth factor receptor (EGFR)-tyrosine kinase (EGFR-TK) reversible inhibitor which blocks EGFR phosphorylation and subsequent signal transduction pathways involved in proliferation, metastasis, angiogenesis and apoptosis inhibition. Recently, mutations in the TK domain of the EGFR have been identified in those patients with refractory non-small cell lung cancer who achieved dramatic tumor responses to gefitinib. Although the role of EGFR-TK mutation status in predicting other clinical benefits with gefitinib, i.e. disease stabilization and symptom improvement, is unclear, these findings, along with increasing knowledge of other potential biomarkers of response, are significant developments towards further optimizing the use of gefitinib. Gefitinib has favorable pharmacokinetic and pharmacodynamic properties and low toxicity. No dosage adjustment is required for patient age, body weight, gender, ethnicity or moderate to severe hepatic impairment due to liver metastases. Several clinical studies on gefitinib as monotherapy have demonstrated clinically significant symptom relief, tumor response and good tolerability after failure of chemotherapy-based treatment in non-small cell lung cancer. These studies led to gefitinib approval in many countries as a new therapeutic option for patients with advanced non-small cell lung cancer that failed prior chemotherapy. In contrast to the clinical benefit imparted by gefitinib as monotherapy in patients previously treated with chemotherapy, gefitinib in combination with standard platinum-based chemotherapy in chemonaive patients did not improve either survival or other clinical endpoints in non-small cell lung cancer. This review provides currently available data from clinical studies on gefitinib as monotherapy or in combination with platinum-containing chemotherapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.005 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".