Gefitinib (Iressa, ZD1839) and tyrosine kinase inhibitors: the wave of the future in cancer therapy

Cancer Nurs. 2005 Nov-Dec;28(6):481-6. doi: 10.1097/00002820-200511000-00012.

Abstract

Targeted therapies are one of the latest innovative trends in cancer therapy. The epidermal growth factor receptor (EGFR) is a target found in high concentrations in several solid tumors including lung, breast, colorectal, and brain. Tyrosine kinase inhibitors, such as gefitinib (Iressa, ZD1839), block the EGFR. As a result, there is inhibition of cellular proliferation, promotion of apoptosis, and inhibition of anti-angiogenesis. Gefitinib has demonstrated significant efficacy in non-small-cell lung cancer (NSCLC), leading to FDA approval for treatment of this refractory disease. Phase 2 trials with gefitinib for platinum refractory NSCLC reported disease response and symptom improvement. Early results of phase 2 studies of gefitinib, combined with standard chemotherapy in colorectal cancer, showed a 75% response rate compared with 55% with standard therapy alone. Gefitinib, combined with flutamide, produced an additive growth inhibition in prostate cancer. A phase 2 trial of gefitinib in first-relapse glioblastoma multiforme demonstrated median overall survival from treatment start of 39.4 weeks compared with 40 weeks with standard chemotherapy. Gefitinib is an oral agent with a mild toxicity profile, and thus, may be an optimal addition to chemotherapeutic regimens for some solid tumors. Gefitinib is potentially a vital and useful weapon in the arsenal of cancer therapies.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Administration, Oral
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use*
  • Breast Neoplasms / drug therapy
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Clinical Trials, Phase II as Topic
  • Drug Delivery Systems / methods
  • Drug Delivery Systems / trends
  • Drug Resistance, Neoplasm
  • ErbB Receptors / antagonists & inhibitors
  • Female
  • Forecasting
  • Gastrointestinal Neoplasms / drug therapy
  • Gefitinib
  • Glioblastoma / drug therapy
  • Head and Neck Neoplasms / drug therapy
  • Humans
  • Lung Neoplasms / drug therapy
  • Male
  • Medical Oncology / methods
  • Medical Oncology / trends
  • Neoplasms / drug therapy*
  • Neoplasms / mortality
  • Prostatic Neoplasms / drug therapy
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use*
  • Quinazolines / pharmacology
  • Quinazolines / therapeutic use*
  • Signal Transduction / drug effects
  • Survival Rate
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Quinazolines
  • ErbB Receptors
  • Gefitinib