Efifcacy of Chemotherapy after EGFR-TKIs Resistance in 191 Patients with Unknow EGFR Gene Mutation in Advanced Lung Adenocarcinoma
10.3779/j.issn.1009-3419.2013.10.06
- VernacularTitle:191例EGFR突变状态不明晚期肺腺癌患者EGFR-TKIs耐药后化疗的疗效分析
- Author:
HE PING
1
,
2
,
3
;
WANG YAN
;
YANG SHENG
;
YU SHUFEI
;
WANG ZIPING
;
LI JUNLING
;
WANG BIN
;
HAO XUEZHI
;
WANG HONGYU
;
HU XINGSHENG
;
ZHANG XIANGRU
;
SHI YUANKAI
Author Information
1. 100021北京，中国医学科学院北京协和医学院肿瘤医院内科，抗肿瘤分子靶向药物临床研究北京市重点实验室
2. 101300北京，中国医科大学北京顺义区医院血液肿瘤科
3. 北京市卫生局区县医院
- Keywords:
Lung neoplasms;
Epidermal growth factor receptor tyrosine kinase inhibitor;
Pemetrexed;
Platinum;
Drug resistance
- From:
Chinese Journal of Lung Cancer
2013;(10):529-534
- CountryChina
- Language:Chinese
-
Abstract:
Background and objective Subsequent chemotherapy were needed in patients with advanced pul-monary adenocarcinoma experiencing disease progression atfer epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) treatment. hTe study is to explore factors potentially inlfuencing effcacy of subsequent chemotherapy. Meth-ods One hundred and ninety-one patients with advanced lung adenocarcinoma, who were resistant from EGFR-TKIs and then received subsequent chemotherapy, were identified. Data of patient’s characteristics, responses to chemotherapy and survival time were analyzed retrospectively. Results hTe overall response rate of the pemetrexed-based chemotherapy (9.3%) was higher than non-pemetrexed-based regimen (1.1%), P=0.011. Furthermore, the response in the second-line was more ob-visous [objective response rate (ORR) 14.3%vs 3.7%, P=0.041]. hTe patients who achieved response of partial response (PR) showed longer progression-free survival (PFS) than those who achieved non-PR (PFS 10.1 months and 2.3 months, P=0.012). hTe patients treated with platinum-based chemotherapy had longer PFS and OS than those with non-platinum-based che-motherapy, therefore platinum-based regimen was independent prognosis factors for PFS and OS (PFS:RR=0.634, 95%CI:0.466-0.832, P=0.004;OS:RR=0.666, 95%CI:0.460-0.960, P=0.030), especially the pateients who were aquired EGFR-TKIs resistance and who got drmatic progression from EGFR-TKIs treatment might got more beneifts from platinum-based chemo-therapy. However there was no signiifcant difference in ORR, PFS or OS between patients with TKIs primary resistance and acquired resistance, or between dramtic progression and gradual/local progression. Conclusion hTe patients with advanced lung adenocarcinoma might get beneifts from pemetrexed-based or platinum-based chemotherapy atfer they were EGFR-TKIs resistace.
