MEDLINE (1996 through November 2005), EMBASE (1996 through 2005, week 47), CANCERLIT (1975 through October 2002), and the Cochrane Library (2005, Issue 4) databases were searched. The subject headings "carcinoma, non-small-cell lung," "lung neoplasms," "lung non small cell cancer," "lung carcinogenesis," "lung adenocarcinoma," "lung alveolus cell carcinoma," "lung squamous cell carcinoma," "erlotinib," "gefitinib," and "epidermal growth factor receptor" were combined with each of the following phrases used as text words: "non small cell lung," "Iressa," "gefitinib," "ZD1839," "Tarceva," "erlotinib," "OSI774," and "EGFR-TK". These terms were then combined with the search terms for the following publication types and study designs: practice guidelines, systematic reviews, meta-analyses, randomized controlled trials, clinical trials, phase II clinical trials, phase III clinical trials, and cohort analyses.
In addition, conference proceedings of the American Society of Clinical Oncology (ASCO) (1999-2005), the European Cancer Conference (ECCO) (1999-2003), the International Association for the Study of Lung Cancer (IASLC) (2003-2005) and the European Society for Medical Oncology (ESMO) (1999-2004) were searched for abstracts of relevant trials. The Canadian Medical Association Infobase (http://mdm.ca/cpgsnew/cpgs/index.asp) and the National Guideline Clearinghouse (http://www.guideline.gov/) were also searched for existing evidence-based practice guidelines.
Relevant articles and abstracts were selected and reviewed by two reviewers, and the reference lists from those sources were searched for additional trials, as were the reference lists from relevant review articles.
Study Selection Criteria
Inclusion Criteria
- Practice guidelines on the use of gefitinib or erlotinib as treatment for non-small cell lung cancer (NSCLC); or
- Meta-analyses or randomized trials (phase II or phase III) comparing gefitinib or erlotinib, alone or in combination with chemotherapy, to placebo, best supportive care (BSC), or chemotherapy, or comparing different doses or schedules of gefitinib or erlotinib; and
- Fully published papers or published abstracts of trials that reported at least one of the following outcomes by treatment group: symptom control, quality of life (QOL), tumour response rate, or survival.
Exclusion Criteria
- Pilot trials, dose-escalation trials, or case series (including expanded access programs) studies
- Letters and editorials that reported clinical trial outcomes
- Papers published in a language other than English, which were excluded because resource limitations do not allow for translation services