Yen-Han Tseng1,2, Hsiu-Ying Hung3, Yi-Chen Sung3, Yen-Chiang Tseng4, Yu-Chin Lee1, Jacqueline Whang-Peng5, Yuh-Min Chen1,2,5. 1. a Department of Chest Medicine , Taipei Veterans General Hospital , Taipei , Taiwan , Republic of China. 2. b School of Medicine , National Yang-Ming University , Taipei , Taiwan , Republic of China. 3. c Department of Nursing , Taipei Veterans General Hospital , Taipei , Taiwan , Republic of China. 4. d Division of Thoracic Surgery, Department of Surgery , Taipei Veterans General Hospital , Taipei , Taiwan , Republic of China. 5. e Taipei Cancer Center , Taipei Medical University , Taipei , Taiwan , Republic of China.
Abstract
INTRODUCTION: Salvage chemotherapy is frequently used when tumour epidermal growth factor receptor (EGFR) mutated patients experience disease progression with first-line EGFR-tyrosine kinase inhibitor (TKI) treatment. However, the efficacy of salvage chemotherapy is still unknown. METHODS: We retrospectively reviewed the chart records of our pulmonary adenocarcinoma patients between 2010 and 2013. RESULTS: Five hundred and six of the 1240 stage IV adenocarcinoma patients had an EGFR mutation and 338 received first-line EGFR-TKI treatment. In all, 169 patients in this group received salvage chemotherapy after failure of EGFR-TKI, and 102 patients were eligible for this study. The chemotherapy response rate of these 102 patients was 24.5%, with a median progression-free survival (PFS) of 4.5?months, and median survival time was 14.6?months. Patients who received pemetrexed-based chemotherapy had longer PFS and overall survival (OS), although the extent was statistically insignificant. Progression-free survival and OS were longer for patients who received combination chemotherapy than single-agent chemotherapy. CONCLUSIONS: Pemetrexed-based combination chemotherapy is preferred before a more efficient treatment strategy is found.
INTRODUCTION: Salvage chemotherapy is frequently used when tumourepidermal growth factor receptor (EGFR) mutated patients experience disease progression with first-line EGFR-tyrosine kinase inhibitor (TKI) treatment. However, the efficacy of salvage chemotherapy is still unknown. METHODS: We retrospectively reviewed the chart records of our pulmonary adenocarcinomapatients between 2010 and 2013. RESULTS: Five hundred and six of the 1240 stage IV adenocarcinomapatients had an EGFR mutation and 338 received first-line EGFR-TKI treatment. In all, 169 patients in this group received salvage chemotherapy after failure of EGFR-TKI, and 102 patients were eligible for this study. The chemotherapy response rate of these 102 patients was 24.5%, with a median progression-free survival (PFS) of 4.5?months, and median survival time was 14.6?months. Patients who received pemetrexed-based chemotherapy had longer PFS and overall survival (OS), although the extent was statistically insignificant. Progression-free survival and OS were longer for patients who received combination chemotherapy than single-agent chemotherapy. CONCLUSIONS:Pemetrexed-based combination chemotherapy is preferred before a more efficient treatment strategy is found.