Relief of symptoms after gefitinib is associated with improvement of rest/activity rhythm in advanced lung cancer

Weread with interest the article by Bezjak et al1
on the clinical benefits induced by erlotinib treatment in patients with
advanced non–small-cell lung cancer(NSCLC)progressing after prior
chemotherapy. The authors report that patients receiving erlotinib
had significantly longer median time to deterioration of dysphnea,
cough, and pain as compared with placebo controls. Interestingly,
quality of life (QOL) improvement was observed in approximately
22% of patients with progressive disease. These results substantially
confirm those of the Iressa Dose Evaluation for Advanced Lung Cancer
(IDEAL 1 and IDEAL 2) trials of single agent gefitinib in pretreated
patients with NSCLC, where symptom improvement was found in
approximately 40% of the patients whereas objective responses were
observed in 12% to 18%.2 The reported discordance between tumor
response and QOL improvement raises the possibility that epidermal
growth factor receptor (EGFR) tyrosine kinase inhibitors may exert
their effects not only on tumor, but also on the host.