Efficacy and safety of docetaxol, pemetrexed and EGFR-TKIs as second-line treatment for patients with advanced non-small-cell lung cancer.
- VernacularTitle:多西他赛培美曲塞和表皮生长因子受体酪氨酸激酶抑制剂二线治疗晚期非小细胞肺癌的近期疗效与安全性
- Author:
Ru-xia ZHANG
1
;
Dong-yan CAI
;
Xiao-hong WU
;
Dong HUA
Author Information
- Publication Type:Journal Article
- MeSH: Adenocarcinoma; drug therapy; pathology; Aged; Antimetabolites, Antineoplastic; therapeutic use; Antineoplastic Agents; therapeutic use; Carcinoma, Non-Small-Cell Lung; drug therapy; pathology; Disease-Free Survival; Erlotinib Hydrochloride; Female; Glutamates; therapeutic use; Guanine; analogs & derivatives; therapeutic use; Humans; Lung Neoplasms; drug therapy; pathology; Male; Neoplasm Staging; Pemetrexed; Protein Kinase Inhibitors; therapeutic use; Quinazolines; therapeutic use; Receptor, Epidermal Growth Factor; antagonists & inhibitors; therapeutic use; Survival Rate; Taxoids; therapeutic use
- From: Chinese Journal of Oncology 2012;34(11):869-872
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo compare the efficacy and safety of docetaxol, pemetrexed and EGFR-TKIs in the second-line treatment for patients with advanced non-small cell lung cancer.
METHODSThe clinical data of 170 patients with advanced non-small cell lung cancer who failed standard first-line chemotherapy were reviewed. Those who received docetaxol as second-line therapy were designated as group A (n = 60), those who received pemetrexed as second-line therapy were designated as group B (n = 49), and those who received EGFR-TKIs as second-line therapy were designated as group C (n = 61). PFS and MST were estimated by Kaplan-Meier method and the differences between groups were compared by log-rank test.
RESULTSThe response rate in the groups A, B and C group was 15.0% (9/60), 24.5% (12/49) and 36.1% (22/61), respectively. The PFS after second-line therapy in the groups A, B and C was 5.49 months (95%CI: 4.03 - 6.95 months), 5.42 months (95%CI: 4.23 - 6.60 months) and 9.31 months (95%CI: 6.88 - 11.73 months), respectively (P = 0.045). The MST after second-line therapy in the groups A, B and C was 14.89 months (95%CI: 11.23 - 18.55 months), 15.81 months (95%CI: 12.11 - 19.52 months) and 17.47 months (95%CI: 13.38 - 21.56 months), respectively (P = 0.574). Regression analysis showed that the performance status score (PS) and response for second-line treatment are independent prognostic factors in each sub-group, and pathological type is an independent prognostic factor in the group C (P = 0.003).
CONCLUSIONSThe safety of the three drugs used as second-line treatment for patients with advanced non-small-cell lung cancer, who failed standard first-line chemotherapy, is comparable, but the EGFR-TKIs group has the highest response rate, and the EGFR-TKIs group has the longest PFS with a statistically significant difference, while there is no significant difference in MST among the three groups. When patients receive second-line treatment, the performance status < 2 and the response rate for second-line treatment are independent prognostic factors. Furthermore, pathological type (adenocarcinoma) is also an independent prognostic factor for EGFR-TKIs as second-line treatment.
