BACKGROUND: The optimal treatment sequence of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) and pemetrexed in previously treated advanced lung adenocarcinoma patients is currently unknown. METHODS: This retrospective study explored two sequential regimens incorporating EGFR TKIs and pemetrexed in advanced lung adenocarcinoma patients who had failed standard first-line chemotherapy. The medical records of 83 patients were carefully reviewed. 45 patients who received second-line EGFR TKIs followed by third-line pemetrexed were grouped as cohort A. 38 patients who received a strategy with the reverse sequence were grouped as cohort B. Progression-free survival, disease control duration and survival time were compared between the two cohorts. RESULTS: Median survival time is significantly longer in cohort A compared with cohort B (23.615 months vs. 16.269 months, HR: 0.549, 95% CI: 0.308-0.979, P = 0.042). Median disease control duration is 17.463 months in cohort A versus 11.587 months in cohort B (HR: 0.700, 95% CI: 0.409-1.196, P = 0.191). Median progression-free survival with second-line EGFR TKIs is significantly longer than second-line pemetrexed (8.056 months vs. 4.200 months, HR: 0.462, 95% CI: 0.281-0.758, P = 0.001). Median progression-free survival with third-line EGFR TKIs is 6.885 months versus 7.624 months with third-line pemetrexed (HR: 0.462, 95% CI: 0.605-1.767, P = 0.902). The rate of response to EGFR TKIs is higher in second-line setting than in third-line (44% vs. 34%). CONCLUSIONS: We hypothesized that for EGFR-mutated patients, second-line EGFR TKIs followed by third-line pemetrexed is preferable to the reverse sequence.
BACKGROUND: The optimal treatment sequence of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) and pemetrexed in previously treated advanced lung adenocarcinomapatients is currently unknown. METHODS: This retrospective study explored two sequential regimens incorporating EGFR TKIs and pemetrexed in advanced lung adenocarcinomapatients who had failed standard first-line chemotherapy. The medical records of 83 patients were carefully reviewed. 45 patients who received second-line EGFR TKIs followed by third-line pemetrexed were grouped as cohort A. 38 patients who received a strategy with the reverse sequence were grouped as cohort B. Progression-free survival, disease control duration and survival time were compared between the two cohorts. RESULTS: Median survival time is significantly longer in cohort A compared with cohort B (23.615 months vs. 16.269 months, HR: 0.549, 95% CI: 0.308-0.979, P = 0.042). Median disease control duration is 17.463 months in cohort A versus 11.587 months in cohort B (HR: 0.700, 95% CI: 0.409-1.196, P = 0.191). Median progression-free survival with second-line EGFR TKIs is significantly longer than second-line pemetrexed (8.056 months vs. 4.200 months, HR: 0.462, 95% CI: 0.281-0.758, P = 0.001). Median progression-free survival with third-line EGFR TKIs is 6.885 months versus 7.624 months with third-line pemetrexed (HR: 0.462, 95% CI: 0.605-1.767, P = 0.902). The rate of response to EGFR TKIs is higher in second-line setting than in third-line (44% vs. 34%). CONCLUSIONS: We hypothesized that for EGFR-mutated patients, second-line EGFR TKIs followed by third-line pemetrexed is preferable to the reverse sequence.
Authors: Ming-Sound Tsao; Akira Sakurada; Jean-Claude Cutz; Chang-Qi Zhu; Suzanne Kamel-Reid; Jeremy Squire; Ian Lorimer; Tong Zhang; Ni Liu; Manijeh Daneshmand; Paula Marrano; Gilda da Cunha Santos; Alain Lagarde; Frank Richardson; Lesley Seymour; Marlo Whitehead; Keyue Ding; Joseph Pater; Frances A Shepherd Journal: N Engl J Med Date: 2005-07-14 Impact factor: 91.245
Authors: Kathy D Miller; Linnea I Chap; Frankie A Holmes; Melody A Cobleigh; P Kelly Marcom; Louis Fehrenbacher; Maura Dickler; Beth A Overmoyer; James D Reimann; Amy P Sing; Virginia Langmuir; Hope S Rugo Journal: J Clin Oncol Date: 2005-02-01 Impact factor: 44.544
Authors: Nasser Hanna; Frances A Shepherd; Frank V Fossella; Jose R Pereira; Filippo De Marinis; Joachim von Pawel; Ulrich Gatzemeier; Thomas Chang Yao Tsao; Miklos Pless; Thomas Muller; Hong-Liang Lim; Christopher Desch; Klara Szondy; Radj Gervais; Christian Manegold; Sofia Paul; Paolo Paoletti; Lawrence Einhorn; Paul A Bunn Journal: J Clin Oncol Date: 2004-05-01 Impact factor: 44.544
Authors: Giorgio Vittorio Scagliotti; Purvish Parikh; Joachim von Pawel; Bonne Biesma; Johan Vansteenkiste; Christian Manegold; Piotr Serwatowski; Ulrich Gatzemeier; Raghunadharao Digumarti; Mauro Zukin; Jin S Lee; Anders Mellemgaard; Keunchil Park; Shehkar Patil; Janusz Rolski; Tuncay Goksel; Filippo de Marinis; Lorinda Simms; Katherine P Sugarman; David Gandara Journal: J Clin Oncol Date: 2008-05-27 Impact factor: 44.544
Authors: Vincent A Miller; Mark G Kris; Neelam Shah; Jyoti Patel; Christopher Azzoli; Jorge Gomez; Lee M Krug; William Pao; Naiyer Rizvi; Barbara Pizzo; Leslie Tyson; Ennapadam Venkatraman; Leah Ben-Porat; Natalie Memoli; Maureen Zakowski; Valerie Rusch; Robert T Heelan Journal: J Clin Oncol Date: 2004-03-15 Impact factor: 44.544
Authors: Edward S Kim; Vera Hirsh; Tony Mok; Mark A Socinski; Radj Gervais; Yi-Long Wu; Long-Yun Li; Claire L Watkins; Mark V Sellers; Elizabeth S Lowe; Yan Sun; Mei-Lin Liao; Kell Osterlind; Martin Reck; Alison A Armour; Frances A Shepherd; Scott M Lippman; Jean-Yves Douillard Journal: Lancet Date: 2008-11-22 Impact factor: 79.321