Published at www.nejm.org August 19, 2009

從最近的NEJM和lancet就可以看出,EBM當道的理由啦

先提供一下廠商資料,最近的期刊都會特別將廠商這點附上,怕被人家事後挑毛病吧

Supported by AstraZeneca.

Dr. Mok reports receiving consulting fees from Roche, AstraZeneca, Pfizer, and Eli Lilly, lecture fees from Roche, AstraZeneca, and Eli Lilly, and a research grant to the Chinese Lung Cancer Research Foundation from AstraZeneca, Hong Kong; Dr. Wu, receiving consulting fees from AstraZeneca, Roche, Eli Lilly, and Pfizer and lecture fees from AstraZeneca, Roche, and Eli Lilly; Dr. Thongprasert, receiving consulting fees from AstraZeneca, Pfizer, and Sanofi-Aventis, lecture fees from AstraZeneca, Eli Lilly, and Sanofi-Aventis, and grant support from AstraZeneca, Sanofi-Aventis, and Pfizer; Dr. C.-H. Yang, receiving consulting fees and lecture fees from AstraZeneca; Dr. Saijo, owning equity in Takeda and receiving grant support from AstraZeneca, Chugai, Takeda, and Taiho; Dr. Ichinose, receiving lecture fees from Chugai, Kyowa Hakko, AstraZeneca, and Sanofi-Aventis; Dr. Ohe, receiving lecture fees from AstraZeneca, Eli Lilly, Chugai, Bristol-Myers Squibb, and Sanofi-Aventis; Dr. Chewaskulyong, receiving lecture fees from AstraZeneca and Roche; Dr. Jiang, Miss Duffield, Miss Watkins, and Dr. Armour, being salaried employees of AstraZeneca and owning equity in AstraZeneca; and Dr. Fukuoka, receiving lecture fees from AstraZeneca and Chugai. No other potential conflict of interest relevant to this article was reported.

We thank the patients and investigators for their participation in this study and Annette Smith, Ph.D., from Complete Medical Communications, who provided editing support funded by AstraZeneca.

直接看結論的最後一段好了,剩下的有興趣在去深入探討他的研究方法及結果:

The efficacy of gefitinib seen in this study was coupled with lower incidences of alopecia, nausea, vomiting, neurotoxic symptoms, and myelosuppression than those seen with carboplatin–paclitaxel. Among 607 patients who received gefitinib and who were included in the safety analysis, interstitial-lung-disease events developed in only 16 (2.6%), 3 of whom (0.5%) died.

In summary, this study shows that first-line therapy with gefitinib as compared with carboplatin–paclitaxel prolongs progression-free survival, increases the objective response rate, and improves quality of life among clinically selected patients with non–small-cell lung cancer. The presence of an EGFR mutation was a robust predictor of improved progression-free survival with gefitinib, as compared with carboplatin–paclitaxel, and of the benefit of gefitinib with respect to the objective response rate, indicating that patients in whom an EGFR mutation has been identified will benefit most from first-line therapy with gefitinib.

 

 

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