A randomized controlled study of erlotinib versus pemetrexed combined with cisplatin in neoadjuvant therapy of stage ⅢA EGFR-mutant lung adenocarcinoma
10.3760/cma.j.issn.0253-3766.2018.02.010
- VernacularTitle: 厄洛替尼与培美曲塞加顺铂方案新辅助治疗ⅢA期表皮生长因子受体突变型肺腺癌的随机对照研究
- Author:
Wenqing CHEN
1
;
Pei LI
1
;
Qiang WANG
1
;
Yijun ZHANG
1
;
Hongyu LI
1
;
Xintian JIN
1
;
Song YAN
1
;
Guofeng KOU
1
;
Sanli CAI
1
;
Gang LIU
1
Author Information
1. Department of Thoracic Oncosurgery-3, Jilin Province Cancer Hospital, Changchun 130021, China
- Publication Type:Clinical Trail
- Keywords:
Lung neoplasms;
Adenocarcinoma;
Neoadjuvant therapy;
Molecular targeted therapy;
Epidermal growth factor receptor
- From:
Chinese Journal of Oncology
2018;40(2):133-137
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the feasibility, efficacy and safety of epidermal growth factor receptor-tyrosine kinase inhibitors(EGFR-TKIs) for neoadjuvant therapy.
Methods:Eighty-six patients with stage ⅢA EGFR-mutant lung adenocarcinoma were assigned to 2 groups (n=43 in each group) according to the random number table method: neoadjuvant targeted therapy group (single oral dose of erlotinib 150 mg per day, for 9 weeks) and neoadjuvant chemotherapy group (2 cycles of pemetrexed combined with cisplatin chemotherapy followed by 3- week discontinuation). Surgical treatment was underwent after imaging efficacy evaluation.
Results:In neoadjuvant targeted therapy group, 4 achieved complete response (CR), 25 achieved partial response (PR), giving an objective response rate (ORR) of 67.4%. In pathological response, 8 patients had grade Ⅰ, 20 patients had grade Ⅱ, giving a pathological response rate of 65.1%. The most frequent adverse events (AEs) were rash and diarrhea. In neoadjuvant chemotherapy group, 2 had CR and 17 had PR, giving an ORR of 44.2%. In pathological response, 3 patients had grade Ⅰ, 15 patients had grade Ⅱ, giving a pathological response rate of 41.9%. The main AEs were hematologic toxic effects. The ORR, histological efficacy and hematologic toxicity showed statistical significance between the two groups (P<0.05). The neoadjuvant targeted therapy group had 90.7% resection rate, (299.8±23.4) ml of hemorrhage volume during operation, (5.2±0.4) days of extubation time and 9.3% postoperative complication rate. Corresponding results were 83.7%, (308.9±22.7) ml, (5.4±0.6) days and 11.6% in neoadjuvant chemotherapy group, which showed no statistical significance (P>0.05).
Conclusions:Neoadjuvant targeted treatment for stage ⅢA lung adenocarcinoma harboring EGFR mutations. The regimen could be considered as a choice of neoadjuvant treatment for patients with stage ⅢA EGFR-mutant lung adenocarcinoma.
