Analysis of prognostic factors for the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer
10.3760/cma.j.issn.1673-4904.2018.08.012
- VernacularTitle: 培美曲塞/多西他赛二线化疗晚期非小细胞肺癌预后因素分析
- Author:
Jie LIU
1
;
Xiuwen WANG
Author Information
1. Department of Chemotherapy, Qilu Hospital, Shandong University, Ji′nan 250000, China
- Publication Type:Journal Article
- Keywords:
Carcinoma, non-small-cell lung;
Pemetrexed;
Docetaxel;
Survival analysis
- From:
Chinese Journal of Postgraduates of Medicine
2018;41(8):717-723
- CountryChina
- Language:Chinese
-
Abstract:
Objective:A large phase Ⅲ comparison trial of pemetrexed to docetaxel showed similar efficacy for treating advanced non-small-cell lung cancer. In this paper, the prognostic factors for the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer were retrospective analyzed. At the same time, the impact of first-line chemotherapy on the outcome of second-line chemotherapy was analyzed.
Methods:For 134 patients with advanced NSCLC were randomly assigned to receive pemetrexed 500 mg/m2 or docetaxel 75 mg/m2 on day 1 of a 21-day cycle. According to the type of first-line therapy, patients were divided into three groups: platinum combined with gemcitabine group (50 cases), platinum combined with taxane group (38 cases) and other therapies group (46 cases). Univariate and multivariate analysis methods were used to compute the relationship between prognostic factors, including age, gender, stage at diagnosis, performance status, best response to first-line therapy and time elapsed from first- to second-line therapy, and patients′ overall survival.
Results:Through multivariate analysis we found patients′ gender, stage at diagnosis, performance status and best response to first-line therapy was significant correlatedion with overall survival. Among them, median survival time for female and male patients was 9.2 and 6.8 months respectively with a significant difference between them (P<0.05). In addition, median survival time for stage Ⅲ and Ⅳ was 9.3 and 7.4 months respectively with a significant difference (P<0.05). At the same time, median survival time for ECOG PS 0, 1 and 2 was 12.1, 7.8 and 2.9 months with a significant difference (P<0.01). For complete/partial remission patients, stable condition patients, disease progression patients after first-line therapy, the median survival time was 15.4, 10.7 and 4.3 months respectively with a significant difference (P<0.01). Additional, median survival time for first-line therapy with platinum combined with gemcitabine was significant longer than that treated with platinum combined with taxane and other therapies:8.9 months vs. 6.8 months vs. 7.4 months.
Conclusions:Four prognostic factors including patients′ gender, performance status, stage at diagnosis and best response to first-line therapy should be considered in the second-line therapy setting with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer. This paper has potential clinical value in the second-line therapy with pemetrexed or docetaxel for patients with advanced NSCLC.
