Gefitinib vs. Erlotinib for Previously Treated Advanced Lung Adenocarcinoma

Four epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors are currently FDA-approved for EGFR-mutated non–small-cell lung cancer (NSCLC). In frontline EGFR-mutated patients, afatinib, gefitinib, and erlotinib are available, and osimertinib is approved for T790M patients. Gefitinib and erlotinib are also approved for salvage use in EGFR–wild-type NSCLC.

Now, the West Japan Oncology Group has conducted a multicenter, randomized, open-label, noninferiority, phase III trial (WJOG 5108L), in which 561 previously chemotherapy-treated patients with advanced lung adenocarcinoma (71% had EGFR mutations) were randomized to receive gefitinib or erlotinib. The primary endpoint was progression-free survival (PFS) noninferiority with gefitin…