Efficacy of platinum-based combination chemotherapy in advanced lung adenocarcinoma harboring sensitive epidermal growth factor receptor (EGFR) mutations with acquired resistance to first-line EGFR tyrosine kinase inhibitor (TKI). (2016)

• Record Type: Journal Article
• Authors: Hsu, Ping-Chih; Liu, Chien-Ying; Li, Shih-Hong; Huang, Shih-How; Wang, Chih-Liang; Kuo, Chih-Hsi; Chung, Fu-Tsai; Chen, Chih-Hung; Yu, Chih-Teng; Yang, Cheng-Ta
• Is Part Of: Cancer treatment and research communications. Number 9(2016)
• Page Start: 48
• Page End: 55
• Publication Date: 2016
• Subjects: Epidermal growth factor receptor (EGFR) -- Tyrosine kinase inhibitors (TKI) -- Pemetrexed -- Maintenance therapy -- Overall survival (OS) -- Progression-free survival (PFS)
• DOI: 10.1016/j.ctarc.2016.07.005
• Languages: English
• ISSNs: 2468-2942

Abstract

Abstract: Background: The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) eventually fails in treating advanced lung adenocarcinoma harboring sensitive EGFR mutations because of acquired resistance. In clinical practical setting, platinum-doublet chemotherapy has been frequently performed after failure of first-line EGFR-TKIs. The efficacy of different regimens was compared. Methods: From January 2012 to December 2013, 160 patients with mutated EGFR receiving first-line EGFR-TKIs and second-line chemotherapy were analyzed retrospectively. Sixty-eight patients received pemetrexed-based therapy and among them, 61 were in combination with cisplatin. Ninety-two patients received non-pemetrexed-based therapy and among them, 79 were combined with cisplatin. Results: The progression-free survival of first-line EGFR-KI was 9.0 and 8.6 months for pemetrexed and non-pemetrexed treatment groups respectively (HR: 0.9146, 95% CI: 0.6656 to 1.257, P =0.5818). The median progression-free survival (PFS) of second-line therapy was 8.3 and 5.6 months for pemetrexed and non-pemetrexed treatment groups respectively (HR: 0.4217, 95% CI: 0.2952 to 0.6025, P =0.0001). The median overall survival (OS) after first-line EGFR-TKIs was 16.9 and 10.3 months for pemetrexed and non-pemetrexed groups respectively (HR: 0.5160, 95% CI: 0.3381 to 0.7873, P =0.0021). For those receiving pemetrexed continuous maintenance therapy, there was 18.7 months of survival after first-line EGFR-TKI, compared to 11.1 months for those without maintenance (HR: 0.4012, 95% CI: 0.2577 to 0.6247, P <0.0001). Conclusion: The efficacy of pemetrexed was superior to other chemotherapeutic agents in second line treatment for patients with lung adenocarcinoma harboring sensitive EGFR mutations after first-line EGFR-TKI therapy. Continuous maintenance pemetrexed therapy also improved the PFS and OS.