Survival Benefit and Genetic Profile of Pemetrexed as Initial Chemotherapy in Selected Chinese Patients With Advanced Lung Adenocarcinoma
| Autor: | Changli Wang, Qiu-Ying Jiang, Jianying Zhou, Bo Zhu, Wang Lifeng, Qisen Guo, Qing Zhou, Guosheng Feng, Ming-Feng Zhang, Yi Hu, Jing-Min Zhou, Kaican Cai, Yun Fan, Guo-Wu Wu, Xi Chen, Xia Song, Xizhao Sui, Xiao-Hong Cai, Lin Yang, Xiao-Ling Li, Yi-Long Wu, Jun Jia, Ya-Jie Gao, Huijuan Wang, Xiaoqing Liu, Cong-Ying Xie, Xiaorong Dong, Shundong Cang, Ying Zhu, Mingfang Zhao, Wen Lin, Li-Jun Peng, Zhanhong Xie, Gongyan Chen, Gui-Bin Qiao, Liang-Ming Zhang, Jun Zhao, Xin-Hua Xu, Feng-Xia Chen, Helong Zhang, Bo Jiang, Chunhong Hu, Zhixiong Yang, Long-Hua Guo, Yu Yao, Nong Yang, Jiuwei Cui, Hongmei Zhang, Ying Cheng, Yu Long |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Oncology Cancer Research medicine.medical_specialty medicine.medical_treatment medicine.disease_cause chemotherapy lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Maintenance therapy CDKN2A Internal medicine medicine pemetrexed Original Research Chemotherapy Lung Chinese business.industry medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens lung adenocarcinoma Regimen 030104 developmental biology medicine.anatomical_structure Pemetrexed 030220 oncology & carcinogenesis Adenocarcinoma next-generation sequencing KRAS business medicine.drug |
| Zdroj: | Frontiers in Oncology Frontiers in Oncology, Vol 10 (2020) |
| ISSN: | 2234-943X |
| Popis: | Objective: This study investigated survival in selected Chinese patients with advanced lung adenocarcinoma who received initial chemotherapy with pemetrexed. We also explored the relationship between genetic biomarkers and pemetrexed efficacy.Methods: We retrospectively collected patients (n = 1,047) enrolled in the Chinese Patient Assistance Program from multiple centers who received pemetrexed alone or combined with platinum as initial chemotherapy and continued pemetrexed maintenance therapy for advanced lung adenocarcinoma from November 2014 to June 2017. The outcomes were duration of treatment (DOT) and overall survival (OS). Clinical features were analyzed for their influence on the treatment effect and prognosis. Next-generation sequencing (NGS) was performed to identify genetic biomarkers associated with the efficacy of pemetrexed.Results: The median DOT was 9.1 months (95% CI: 8.5–9.8), and the median OS was 26.2 months (95% CI: 24.2–28.1). OS was positively correlated with DOT (r = 0.403, P < 0.001). Multivariable analysis showed that smoking status and Eastern Cooperative Oncology Group (ECOG) performance status (PS) were independently associated with DOT; smoking status, ECOG PS, targeted therapy, and EGFR/ALK/ROS1 status were independently associated with OS. NGS in 22 patients with available samples showed genes with high mutation rates were: TP53 (54.5%), EGFR (50.0%), MYC (18.2%), and PIK3CA (13.6%). When grouped based on progression-free survival (PFS) reported in the PARAMOUNT study, the DOT > 6.9 months set was associated with PIK3CA, ALK, BRINP3, CDKN2A, CSMD3, EPHA3, KRAS, and RB1 mutations, while ERBB2 mutation was observed only in the DOT ≤ 6.9 months set.Conclusion: This study shows that initial chemotherapy with pemetrexed is an effective regimen for advanced lung adenocarcinoma in selected Chinese patients. There is no specific genetic profile predicting the benefit of pemetrexed found by NGS. Biomarkers predicting the efficacy of pemetrexed need further exploration. |
| Databáze: | OpenAIRE |
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