Pemetrexed plus platinum versus pemetrexed alone in non-small cell lung cancer patients who have progressed after first-line EGFR TKIs.
OBJECTIVES
After failure of first-line epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) in patients with non-small cell lung cancer (NSCLC) harboring EGFR-activating mutation, platinum based combination chemotherapy is recommended. However, it is still unknown which chemotherapeutic regimens result in better outcomes.


MATERIALS AND METHODS
A total of 63 patients who were treated with pemetrexed or pemetrexed/platinum chemotherapy after first line EGFR TKI therapy at Samsung Medical Center were included in our analysis. Baseline clinical characteristics, response rate, toxicities and survival outcomes were compared between the two groups.


RESULTS
Among 63 patients, 29 were treated with pemetrexed (P) alone and 34 were treated with pemetrexed and platinum combination (PC) therapy. The median age, sex and smoking history was not different between the two groups. The overall response rate and disease control rate was 25.9%/44.4% for the P group and 43.5%/75.0% for the PC group (p = 0.154 in response rate, p = 0.017 in disease control rate). Grade 2 or 3 neutropenia was noted only for the PC group (0% vs. 18.8%, p = 0.049). For progression-free survival (PFS), patients treated with PC had more favorable outcomes than patients treated with P alone, although the difference was not statistically significant (5.2 vs. 2.7 months, PC vs. P; p=0.096).


CONCLUSIONS
Based on this retrospective analysis, platinum combination with pemetrexed resulted in a better disease control rate and a tendency toward prolongation of progression-free survival in NSCLC patients who progressed after first-line EGFR TKIs.
['Lee|Su Jin|SJ|', 'Sun|Jong-Mu|JM|', 'Lee|Se Hoon|SH|', 'Ahn|Jin Seok|JS|', 'Park|Keunchil|K|', 'Ahn|Myung-Ju|MJ|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000971:Antineoplastic Combined Chemotherapy Protocols D002289:Carcinoma, Non-Small-Cell Lung D018572:Disease-Free Survival D066246:ErbB Receptors D005260:Female D006801:Humans D008175:Lung Neoplasms D008297:Male D008875:Middle Aged D009154:Mutation D009944:Organoplatinum Compounds D000068437:Pemetrexed D047428:Protein Kinase Inhibitors D011505:Protein-Tyrosine Kinases D012189:Retrospective Studies
Pemetrexed Platinum Non-small cell lung cancer Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs)