Pemetrexed Singlet Versus Nonpemetrexed-Based Platinum Doublet as Second-Line Chemotherapy after First-Line Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitor Failure in Non-small Cell Lung Cancer Patients with EGFR Mutations
Autor: | Dae Seog Heo, Jin Soo Kim, Jong Seok Lee, Dong Wan Kim, Ki Hwan Kim, Sehhoon Park, Yu Jung Kim, Se-Hoon Lee, Tae Min Kim, Se Hyun Kim, Bhumsuk Keam |
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Rok vydání: | 2015 |
Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Lung Neoplasms medicine.drug_class medicine.medical_treatment Pemetrexed Pharmacology Disease-Free Survival Tyrosine-kinase inhibitor Carcinoma Non-Small-Cell Lung Internal medicine medicine Humans Treatment Failure Non-small-cell lung carcinoma Epidermal growth factor receptor Lung cancer Prospective cohort study Protein Kinase Inhibitors Aged Platinum Retrospective Studies Chemotherapy biology business.industry Hazard ratio Retrospective cohort study Middle Aged medicine.disease respiratory tract diseases ErbB Receptors Mutation biology.protein Female Original Article business medicine.drug |
Zdroj: | Cancer Research and Treatment : Official Journal of Korean Cancer Association |
ISSN: | 2005-9256 1598-2998 |
Popis: | Purpose Platinum-based doublet chemotherapy is the treatment of choice for patients with non-small cell lung cancer (NSCLC); however, the role of a platinum-based doublet as second-line therapy after failure of an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for NSCLC patients has not yet been elucidated. The purpose of this study was to compare the clinical efficacy of pemetrexed versus a platinum-based doublet as second-line therapy after failure of EGFR TKI used as first-line therapy for NSCLC patients with EGFR mutations. Materials and methods We designed a multicenter retrospective cohort study of 314 NSCLC patients with EGFR mutations who received an EGFR TKI as first-line palliative chemotherapy. Our analysis included 83 patients who failed EGFR TKI therapy and received second-line cytotoxic chemotherapy. Results Forty-six patients were treated using a platinum-based doublet and 37 patients were treated using singlet pemetrexed. The overall response rates of patients receiving a platinum-based doublet and patients receiving pemetrexed were17.4% and 32.4%, respectively (p=0.111). The median progression-free survival (PFS) of patients receiving pemetrexed was significantly longer than that of patients receiving a platinum-based doublet (4.2 months vs. 2.7 months, respectively; p=0.008). The hazard ratio was 0.54 (95% confidence interval, 0.34 to 0.86; p=0.009). Conclusion Our retrospective analysis found that second-line pemetrexed singlet therapy provided significantly prolonged PFS compared to second-line platinum-based doublet chemotherapy for NSCLC patients with EGFR mutations who failed first-line EGFR TKI. Conduct of prospective studies for confirmation of our results is warranted. |
Databáze: | OpenAIRE |
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