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Gefitinib, erlotinib increased risk for interstitial lung disease in patients with advanced NSCLC
Patients with advanced non–small cell lung cancer treated with gefitinib and erlotinib demonstrated a significant increased risk for all-grade and fatal interstitial lung disease events, according to results of a systematic review and meta-analysis.
Erlotinib (Tarceva, Genentech) and gefitinib (Iressa, AstraZeneca), both of which are oral epidermal growth factor receptor tyrosine kinase inhibitors, are commonly used during treatment of advanced NSCLC. However, the overall risk for interstitial lung disease events are not known.
In the current study, researchers pooled data from PubMed on abstracts presented at the ASCO and European Society for Medical Oncology meetings between 2000 and 2012. They evaluated 29 randomized controlled trials to determine the incidence and relative risk for interstitial lung disease associated with these EGFR TKIs in 15,618 patients with advanced NSCLC.
The overall incidence for all-grade interstitial lung disease events among patients treated with gefitinib and erlotinib was 1.2% (95% CI, 0.9-1.6), and the mortality rate was 22.8% (95% CI, 14.6-31).
The relative risk for all-grade events associated with gefitinib and erlotinib was 1.53 (95% CI, 1.13-2.08) compared with controls. Additionally, the relative risk for fatal interstitial lung disease events associated with treatment was 1.96 (95% CI, 1.03-3.72) compared with controls.
When the researchers stratified for drug type, study location, treatment arm and treatment line, they observed no significant differences in relative risk.
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.