Practical Management of Patients With Non–Small-Cell Lung Cancer Treated With Gefitinib

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Abstract
Purpose: The use of gefitinib, the first drug approved to inhibit the epidermal growth factor receptor tyrosine kinase, is indicated in patients with non–small-cell lung cancer with tumors progressive after chemotherapy. The unique mechanism of action of this agent leads to distinctive patterns of response and toxicity in persons with lung cancer. Many of the principles of management relevant to gefitinib are distinct from those with conventional cytotoxic drugs. To meet this need, we present practical guidelines on the use of gefitinib in patients with non–small-cell lung cancer. Methods: This article reviews gefitinib’s indications, dosing, response phenomena, and patterns of relapse in individuals with radiographic response. Results: We present our recommendations for the management of rash and diarrhea caused by this agent. Conclusion: This information can guide practitioners and help them inform their patients about what to expect when they receive gefitinib.