# Gefitinib vs gefitinib plus pemetrexed-carboplatin in EGFR-mutant lung cancer (Tata Memorial)

Source: https://onco.cc/trials/gefitinib-chemo-tmh/  
OnCo record `gefitinib-chemo-tmh` (Trial). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

An Indian trial showed that adding standard chemotherapy to the cheap first-generation pill gefitinib doubled the time lung cancer stayed controlled and cut deaths by more than half.

## Summary

350 patients were randomised (176 gefitinib, 174 gefitinib plus pemetrexed-carboplatin). Median progression-free survival was 16 months with the combination versus 8 months with gefitinib alone (hazard ratio for progression or death 0.51; P<0.001); median overall survival was not reached versus 17 months (hazard ratio for death 0.45; P<0.001); response rates were 75% versus 63%, at the cost of more grade 3 or worse toxicity (51% versus 25%). With the Japanese NEJ009 trial it established EGFR inhibitor plus chemotherapy as an option, and offered a low-cost alternative where osimertinib is unaffordable; the approach later re-emerged in FLAURA2.

## Fields

- Kind: Trial
- Status: positive
- Last checked: 2026-09-10
- Phase: 3
- Setting: Untreated advanced EGFR-mutant non-small-cell lung cancer: gefitinib alone vs gefitinib plus pemetrexed and carboplatin
- Sponsor: Tata Memorial Centre
- Enrolled: 350
- Result: PFS 16 vs 8 months (HR 0.51); OS not reached vs 17 months (HR 0.45).
- Outcomes: Median progression-free survival: Gefitinib + pemetrexed-carboplatin 16 months vs Gefitinib 8 months, HR 0.51

## Sources

- Noronha et al., JCO 2020: https://doi.org/10.1200/JCO.19.01154

## Connected records

- cancers: [EGFR-mutated non-small-cell lung cancer](https://onco.cc/cancers/egfr-mutant-nsclc/), [Non-small-cell lung cancer](https://onco.cc/cancers/nsclc/)
- technologies: [Cytotoxic chemotherapy](https://onco.cc/technologies/cytotoxic-chemotherapy/), [Small-molecule kinase inhibitors](https://onco.cc/technologies/kinase-inhibitors/)
- targets: [EGFR](https://onco.cc/targets/egfr/)
- drugs: [Carboplatin](https://onco.cc/drugs/carboplatin/), [Gefitinib](https://onco.cc/drugs/gefitinib/), [Pemetrexed](https://onco.cc/drugs/pemetrexed/)
- institutions: [Tata Memorial Centre](https://onco.cc/institutions/tata-memorial/)
- terms: [Progression-free survival (PFS)](https://onco.cc/terms/pfs/)
- people: [Kumar Prabhash](https://onco.cc/people/prabhash-kumar/), [Vanita Noronha](https://onco.cc/people/noronha-vanita/)
- bottlenecks: [Most of the world has almost no cancer care](https://onco.cc/bottlenecks/b-global-access/), [Prices and value](https://onco.cc/bottlenecks/b-drug-pricing/)
- key papers: [Gefitinib Versus Gefitinib Plus Pemetrexed and Carboplatin Chemotherapy in EGFR -Mutated Lung Cancer](https://onco.cc/key-papers/paper-noronha-j-clin-oncol/)
- roadmaps: [Targeted therapy roadmap: imatinib → designed for resistance → the undruggable drivers fall](https://onco.cc/roadmaps/targeted-therapy-roadmap/)

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