Multicenter phase II trial of gefitinib first-line therapy followed by chemotherapy in advanced non-small-cell lung cancer (NSCLC): SAKK protocol 19/03

BACKGROUND: Gefitinib is active in patients with pretreated non-small-cell lung cancer (NSCLC). We evaluated the activity and toxicity of gefitinib first-line treatment in advanced NSCLC followed by chemotherapy at disease progression. PATIENTS AND METHODS: In all, 63 patients with chemotherapy-naive stage IIIB/IV NSCLC received gefitinib 250 mg/day. At disease progression, gefitinib was replaced by cisplatin 80 mg/m(2) on day 1 and gemcitabine 1250 mg/m(2) on days 1, 8 for up to six 3-week cycles. Primary end point was the disease stabilization rate (DSR) after 12 weeks of gefitinib. RESULTS: After 12 weeks of gefitinib, the DSR was 24% and the response rate (RR) was 8%. Median time to progression (TtP) was 2.5 months and median overall survival (OS) 11.5 months. Never smokers (n = 9) had a DSR of 56% and a median OS of 20.2 months; patients with epidermal growth factor receptor (EGFR) mutation (n = 4) had a DSR of 75% and the median OS was not reached after the follow-up of 21.6 months. In all, 41 patients received chemotherapy with an overall RR of 34%, DSR of 71% and median TtP of 6.7 months. CONCLUSIONS: First-line gefitinib monotherapy led to a DSR of 24% at 12 weeks in an unselected patients population. Never smokers and patients with EGFR mutations tend to have a better outcome; hence, further trials in selected patients are warranted

Factors of patient satisfaction with medical services: The case of G.P. practices in the U.K.

This paper investigates whether factors previously identified in the literature are also important in the U.K. primary healthcare system. In a survey based on the SERVQUAL scale, 182 patients were personally interviewed. The analysis shows that the demographic variables age and gender are of little importance in determining satisfaction with G.P. services but the fundholding-non-fundholding divide is. For nearly every aspect of G.P. services the results clearly show that patients from fundholding surgeries are happier than patients from non-fundholding surgeries. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: Getinfo@haworth pressinc.com]. © 1999 by The Haworth Press, Inc. All rights reserved