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Clinical pharmacy and clinical trials (including case series)
Evaluation of gefitinib use in a general hospital
  1. M. Sanchez,
  2. M. Gimeno,
  3. M.A. Allende,
  4. M. Arenere,
  5. M.A. Alcácera,
  6. F. Montis
  1. 1Universitary Hospital Clinico Lozano Blesa Pharmacy, Zaragoza, Spain

Abstract

Background Gefitinib, an oral tyrosine kinase inhibitor, is indicated for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with activating mutations of the epidermal growth factor receptor (EGFR).

Purpose To review gefitinib clinical use in patients with NSCLC in a general hospital.

Materials and methods Observational retrospective study of patients who started treatment with gefitinib from May 2010 (inclusion of gefitinib in our hospital formulary) to July 2011. Data source: clinical history and pharmacy department records. Data collected: age, sex, smoker, histologic classification of the tumour, EGFR mutation, line of treatment of gefitinib and treatment duration of gefitinib.

Results 19 patients started treatment with gefitinib (11 female and 8 male), median age was 71 years (46-83). 2 patients were smokers, 4 ex-smokers, 1 passive smoker and 10 non-smokers (2 unknown). 17 patients were classified as adenocarcinoma and 2 as squamous cell NSCLC, 79% of patients had grade IIIB or IV NSCLC. EGFR mutation was positive in 63% of patients (12), negative in 1 patient (off-label use) and 6 patients unknown. Gefitinib was first-line treatment in 42% of patients. Median duration of treatment was 3 months (1-14). At the end of the study period: 9 patients continued treatment with gefitinib, 7 died and 3 were lost to follow-up (probably died). Treatment was well tolerated in all patients.

Conclusions Gefitinib was well tolerated. Mutation EGFR test is needed to achieve treatment efficacy. In our study most patients being treated with gefitinib had advanced NSCLC and, despite treatment with gefitinib, a high percentage of patients died during treatment. This is a short study, so that it is necessary to continue reviewing its clinical use.

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