Abstract:
OBJECTIVE:Gefitinib, a small molecule tyrosine kinase inhibitor, showed a substantial effect as a salvage treatment for patients with advanced non-small cell lung cancer (NSCLC) who had failed prior chemotherapy. Subsequent phase III trials in previously untreated patients have failed to demonstrate such benefit. It was later reported that gefitinib had a positive outcome when used in selected population. RATIONAL:The inconsistent results and the lack published meta-analysis that systematically examined the overall efficacy of gefitinib in the frontline setting in such patients, have prompted the current meta-analysis. METHODS:We selected for analysis only those randomized, peer-reviewed clinical studies where the efficacy of gefitinib-based therapy (GBT) was investigated in chemotherapy naïve patients with locally advanced or metastatic NSCLC. We also included studies where patients were randomized between gefitinib vs. placebo or none after initial chemoradiation or chemotherapy induction offered to all included patients. RESULTS:We identified seven eligible studies involving 2,646 and 1,939 patients randomized to GBT and to control arms, respectively. In mostly unselected population, GBT was not associated with higher objective response rate (ORR), progression-free survival (PFS) (hazard ratio [HR] = 0.97, 95% CI: 0.78-1.20, P = 0.78), or overall survival (OS) (HR = 1.04, 95% CI: 0.95-1.13, P = 0.45) as compared with control interventions. In a fraction of patients with known EGFR mutation status, GBT showed significantly higher ORR among patients with mutant EGFR (odds ratio [OR] = 2.81, 95% CI: 1.71-4.62, P < 0.0001); however, EGFR mutation was not associated with better PFS or OS with GBT. Nevertheless, patients receiving GBT experienced significant improvement in quality of life as compared with those in the control arms. CONCLUSION:We conclude that GBT cannot be recommended for frontline management of patients with advanced NSCLC in unselected patient population.
journal_name
Ann Thorac Medjournal_title
Annals of thoracic medicineauthors
Ibrahim EMdoi
10.4103/1817-1737.65047subject
Has Abstractpub_date
2010-07-01 00:00:00pages
153-60issue
3eissn
1817-1737issn
1998-3557journal_volume
5pub_type
杂志文章abstract::An 18-year-old male presented with 4 weeks' history of productive cough and fever that had started 1 day after alleged ingestion of a plastic whistle. Multiple courses of antibiotics had proved ineffective. Crepitation and a localized wheeze on right chest were observed on clinical examination. Chest radiograph showed...
journal_title:Annals of thoracic medicine
pub_type:
doi:10.4103/1817-1737.33702
更新日期:2007-07-01 00:00:00
abstract::The Saudi Initiative for Asthma (SINA) provides up-to-date guidelines for healthcare workers managing patients with asthma. SINA was developed by a panel of Saudi experts with respectable academic backgrounds and long-standing experience in the field. SINA is founded on the latest available evidence, local literature,...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.56001
更新日期:2009-10-01 00:00:00
abstract::The professional content of sleep medicine has grown significantly over the past few decades, warranting the recognition of sleep medicine as an independent specialty. Because the practice of sleep medicine has expanded in Saudi Arabia over the past few years, a national regulation system to license and ascertain the ...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.105710
更新日期:2013-01-01 00:00:00
abstract::We report a case of pulmonary strongyloidiasis in a patient with large granular lymphocytosis. He was on short-term high dose immunosuppressant therapy. A 77-year-old white male presented to the emergency room with fever and shortness of breath for 10 days. The patient had been diagnosed about 3 months prior to this p...
journal_title:Annals of thoracic medicine
pub_type:
doi:10.4103/1817-1737.78432
更新日期:2011-04-01 00:00:00
abstract::Chronic cough is associated with repetitive injury to the upper airway and trachea, which can lead to an underdiagnosed pathology known as "cough-induced" laryngotracheitis (CILT). In this report, we describe a case of CILT that responded well to dual therapy. ...
journal_title:Annals of thoracic medicine
pub_type:
doi:10.4103/atm.ATM_21_18
更新日期:2018-07-01 00:00:00
abstract:CONTEXT:Asthma is a chronic airway disorder which is associated to the inflammatory cells. Inflammatory and immune cells generate more reactive oxygen species in patients suffering from asthma which leads to tissue injury. AIMS:To investigate the role of oxidant-antioxidant imbalance in disease progression of asthmati...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.102182
更新日期:2012-10-01 00:00:00
abstract:AIM:The aim of this study was to investigate the alterations of pulmonary function tests (PFTs) and their relationship with disease activity in inflammatory bowel diseases (IBDs). METHODS:Sixty-four IBD patients (31 Crohn's disease [CD] and 33 ulcerative colitis [UC]) and thirty healthy individuals (controls) were stu...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.191877
更新日期:2016-10-01 00:00:00
abstract::Pleural effusion is considered to be a rare manifestation of pulmonary sarcoidosis, but hemorrhagic effusion secondary to it is a very uncommon clinical presentation. This case is reported due to the rare manifestation in pulmonary sarcoidosis presenting clinically as hemorrhagic pleural effusion. ...
journal_title:Annals of thoracic medicine
pub_type:
doi:10.4103/1817-1737.44783
更新日期:2009-01-01 00:00:00
abstract::Swyer-James-MacLeod (SJM) syndrome is a chronic, progressive lung disease as a result of infection and bronchial obstruction that ultimately leads to emphysema. It is associated with chronic cough, sputum production and recurrent chest infections and is occasionally seen in women of reproductive age. The radiological ...
journal_title:Annals of thoracic medicine
pub_type:
doi:10.4103/1817-1737.37976
更新日期:2008-01-01 00:00:00
abstract::The reported studies suggest a role for eosinophils in the pathogenesis of cough variant asthma. In the present study, the expired breath condensate level of hydrogen peroxide and pH were determined in patients with cough variant asthma and compared to subjects with classical asthma, with chronic cough nonasthmatic an...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.30357
更新日期:2007-01-01 00:00:00
abstract::This paper summarizes the roundtable discussion from the Second International Patient Safety Conference held in April 9-11, 2013, Riyadh, Saudi Arabia. The objectives of the roundtable discussion were to: (1) review the conceptual framework for building capacity in quality and safety in critical care. (2) examine exam...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.118480
更新日期:2013-10-01 00:00:00
abstract::[This corrects the article on p. 100 in vol. 10, PMID: 25829960.]. ...
journal_title:Annals of thoracic medicine
pub_type: 已发布勘误
doi:10.4103/1817-1737.160849
更新日期:2015-07-01 00:00:00
abstract::Tracheobronchial obstruction along with compression of pulmonary vessels is a rare complication after stenting of aortic aneurysm. We present this rare situation in a young patient who underwent stenting of traumatic thoracic aortic aneurysm and developed this near fatal complication and also the conservative manageme...
journal_title:Annals of thoracic medicine
pub_type:
doi:10.4103/1817-1737.74275
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Ventilator-associated pneumonia (VAP) is one of the most serious hospital-acquired infections to occur among mechanically ventilated patients. Many risk factors for VAP have been identified in the literature; however, there is a lack of studies examining the association between endotracheal tube (ETT) repo...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/atm.ATM_26_19
更新日期:2019-10-01 00:00:00
abstract:STUDY OBJECTIVES:Obstructive sleep apnea (OSA) is common in adult populations. Accumulating data indicate that it is independently associated with a variety of cardiovascular diseases and has prognostic importance in affected cases. In this study, we aimed to evaluate coronary flow reserve (CFR) in patients with OSA an...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/atm.ATM_195_16
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Pulmonary rehabilitation (PR) programs proven to be one of the most effective treatment options for respiratory diseases; yet, they are not well-established in hospitals in Saudi Arabia. AIM:To determine the main barriers for setting up PR programs in Saudi Arabia. METHODS:A cross-sectional study was condu...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.180028
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Physicians may experience periods of acute sleep deprivation while on-call, in addition to baseline chronic sleep deprivation which may affect physicians' performance and patients' safety. The purpose of this study was to determine the effect of acute sleep deprivation due to working long on-ca...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.105715
更新日期:2013-01-01 00:00:00
abstract:BACKGROUND:Videothoracoscopic surgery leads to general organ hypoperfusion by reducing mean arterial pressure, systemic vascular resistance, and end-diastolic volume index. Oxidative stress occurs as a result of hypoperfusion. Evaluation of the short-term effects of videothoracoscopic sympathectomy on serum ischemia-mo...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.172298
更新日期:2016-01-01 00:00:00
abstract:INTRODUCTION:Prolonged use of oral corticosteroids is a risk factor for osteoporosis. However, the effect of inhaled corticosteroids (ICS) on bone mineral density (BMD) of asthmatic patients remains controversial. OBJECTIVES:We aimed to determine the prevalence of osteopenia and osteoporosis in our patients with asthm...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.94522
更新日期:2012-04-01 00:00:00
abstract:INTRODUCTION:Treatment-emergent central sleep apnea (TECSA) is the appearance of central apneas and hypopneas after significant resolution of the obstructive events has been attained using positive airway pressure (PAP) therapy. The aim of the study was to determine the prevalence of TECSA and to understand what factor...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.185761
更新日期:2016-07-01 00:00:00
abstract:AIMS:Flexible bronchoscopy is a common procedure performed in pulmonary medicine, critical care, and thoracic surgery. In this study, we aimed to assess the prevalence and predictors of anxiety in patients undergoing diagnostic bronchoscopy. METHODS:This is a prospective study conducted at King Abdulaziz University Ho...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/atm.ATM_38_19
更新日期:2019-07-01 00:00:00
abstract::We report a case of bronchial Dieulafoy's disease in the pediatric age. Angio-computed tomography scan and arteriography addressed us to diagnosis. Bronchial endoscopy with biopsy was avoided due to the high risk of developing a life-threatening hemorrhage. Transcatheter embolization of the bleeding bronchial artery w...
journal_title:Annals of thoracic medicine
pub_type:
doi:10.4103/atm.ATM_163_20
更新日期:2020-10-01 00:00:00
abstract:CONTEXT:Bronchoscopic intervention can provide immediate relief from suffocation and an opportunity for additional treatment in patients with malignant airway obstruction. However, few studies have specifically identified prognostic factors affecting the survival of advanced lung or esophageal cancer patients receiving...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.109818
更新日期:2013-04-01 00:00:00
abstract::Pulmonary hypertension (PH) in the Intensive Care Unit (ICU) may be due to preexisting pulmonary vascular lung disease, liver disease, or cardiac diseases. PH also may be caused by critical illnesses, such as acute respiratory distress syndrome (ARDS), acute left ventricular dysfunction and pulmonary embolism, or may ...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.134056
更新日期:2014-07-01 00:00:00
abstract::Novel coronavirus disease 2019 (COVID-19) is known to cause severe pneumonia and acute respiratory distress syndrome which may lead to death. Several treatments have been tested in the race to find a treatment regimen for this deadly viral infection. Tocilizumab, a recombinant humanized anti-interleukin-6 receptor mon...
journal_title:Annals of thoracic medicine
pub_type:
doi:10.4103/atm.ATM_286_20
更新日期:2020-07-01 00:00:00
abstract::A 12-hour-old male infant presented with prolapsed abdominal content through a defect on left side of chest wall with respiratory distress. A thorough clinical examination suggested absence of ectopia cordis, abdominal wall defect, and any bony anomaly. The child expired after 6 hours of admission because of respirato...
journal_title:Annals of thoracic medicine
pub_type:
doi:10.4103/1817-1737.41916
更新日期:2008-07-01 00:00:00
abstract::Chronic liver disease is one of the leading causes of mortality and morbidity in the worldwide adult population. Liver transplant is the gold standard therapy for end-stage liver disease and many patients are on the waiting list for a transplant. A variety of pulmonary disorders are encountered in cirrhotic patients. ...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.82436
更新日期:2011-07-01 00:00:00
abstract::Bronchiolitis obliterans organizing pneumonia (BOOP) was first described in the early 1980s as a clinicopathologic syndrome characterized symptomatically by subacute or chronic respiratory illness and histopathologically by the presence of granulation tissue in the bronchiolar lumen, alveolar ducts and some alveoli, a...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.39641
更新日期:2008-04-01 00:00:00
abstract:OBJECTIVES:The effects of first-line chemotherapy on overall survival (OS) might be confounded by subsequent therapies in patients with small cell lung cancer (SCLC). We examined whether progression-free survival (PFS), post-progression survival (PPS), and tumor response could be valid surrogate endpoints for OS after ...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章
doi:10.4103/1817-1737.146885
更新日期:2015-01-01 00:00:00
abstract::Chronic cough in childhood is associated with a high morbidity and decreased quality of life. Protracted bacterial bronchitis (PBB) seems to be the second most common cause of chronic cough in children under 6 years of age. Its main clinical feature is represented by wet cough that worsens when changing posture and im...
journal_title:Annals of thoracic medicine
pub_type: 杂志文章,评审
doi:10.4103/atm.ATM_12_17
更新日期:2018-01-01 00:00:00