Ondrej Fiala1, Milos Pesek2, Jindrich Finek3, Martin Svaton2, Marek Minarik4, Lucie Benesova5, Zbynek Bortlicek6, Radek Kucera7, Ondrej Topolcan7. 1. Department of Oncology and Radiotherapy, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, Prague, Czech Republic Biomedical Center, Faculty of Medicine in Pilsen, Faculty of Sciences, Charles University in Prague, Prague, Czech Republic fiala.o@centrum.cz. 2. Department of Pneumology, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, Prague, Czech Republic. 3. Department of Oncology and Radiotherapy, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, Prague, Czech Republic. 4. Center for Applied Genomics of Solid Tumours, Genomac Research Institute, Prague, Czech Republic Department of Analytical Chemistry, Faculty of Sciences, Charles University in Prague, Prague, Czech Republic. 5. Center for Applied Genomics of Solid Tumours, Genomac Research Institute, Prague, Czech Republic. 6. Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic. 7. Department of Nuclear Medicine, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, Prague, Czech Republic.
Abstract
BACKGROUND: Pemetrexed and erlotinib represent different agents commonly used for the second-line treatment of patients with advanced-stage non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: We analyzed data of 137 patients with advanced-stage non-squamous NSCLC treated with pemetrexed or erlotinib in the second line. All patients harbored a wild-type epidermal growth factor receptor gene. Genetic testing was performed using a combination of denaturing capillary electrophoresis and direct Sanger sequencing. RESULTS: overall response rate and disease control rate in patients treated with pemetrexed was 20.8% and 62.5% vs. 6.3% and 53.2% in patients treated with erlotinib (p=0.022; p=0.358). Median progression-free and overall survival in patients treated with pemetrexed was 1.6 and 11.3 months vs. 1.9 and 11.4 months in patients treated with erlotinib (p=0.470 and p=0.942, respectively). Erlotinib was associated with skin rash and diarrhea; pemetrexed was associated with hematological toxicity and fatigue. CONCLUSION: A similar efficacy and different, although well-tolerated, toxicity profile of both pemetrexed and erlotinib was shown. Copyright
BACKGROUND:Pemetrexed and erlotinib represent different agents commonly used for the second-line treatment of patients with advanced-stage non-small cell lung cancer (NSCLC). PATIENTS AND METHODS: We analyzed data of 137 patients with advanced-stage non-squamous NSCLC treated with pemetrexed or erlotinib in the second line. All patients harbored a wild-type epidermal growth factor receptor gene. Genetic testing was performed using a combination of denaturing capillary electrophoresis and direct Sanger sequencing. RESULTS: overall response rate and disease control rate in patients treated with pemetrexed was 20.8% and 62.5% vs. 6.3% and 53.2% in patients treated with erlotinib (p=0.022; p=0.358). Median progression-free and overall survival in patients treated with pemetrexed was 1.6 and 11.3 months vs. 1.9 and 11.4 months in patients treated with erlotinib (p=0.470 and p=0.942, respectively). Erlotinib was associated with skin rash and diarrhea; pemetrexed was associated with hematological toxicity and fatigue. CONCLUSION: A similar efficacy and different, although well-tolerated, toxicity profile of both pemetrexed and erlotinib was shown. Copyright