Retrospective efficacy and safety analyses of erlotinib,pemetrexed, and docetaxel in EGFR-mutation-negative patients with previously treated advanced non-squamous non-small-cell lung cancer |
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| Affiliation: | 1. Department of Respiratory Medicine, Kurashiki Central Hospital, Japan;2. Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Japan;3. Division of Pulmonary Medicine, Kobe City Medical Center General Hospital, Japan;4. Department of Thoracic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Japan;5. Department of Thoracic Oncology, National Hospital Organization Toneyama National Hospital, Japan;6. Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Japan;1. Department of Surgical Oncology, University Health Network, University of Toronto, Toronto, Ontario, Canada;2. Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada;1. Fortis C-DOC Center for Diabetes, Fortis Memorial Research Institute, Gurgaon, Haryana, India;2. National Diabetes, Obesity and Cholesterol Foundation (N-DOC), New Delhi, India;3. Diabetes Foundation (India), New Delhi, India;4. Fortis C-DOC Center for Excellence for Diabetes, Metabolic Disease and Endocrinology, New Delhi, India;1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China;2. Department of Radiation Oncology, Zhejiang Cancer Hospital, Zhejiang, China;3. Department of Radiation Oncology, The First Affiliated Hospital to Nanjing Medical University, Jiangsu, China;1. Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota;2. Department of Urology, Mayo Clinic, Rochester, Minnesota;3. Department of Biostatistics, Mayo Clinic, Rochester, Minnesota;4. Department of Oncology, Mayo Clinic, Rochester, Minnesota;1. Division of Hematology-Oncology, Department of Medicine, Chao Comprehensive Cancer Center, University of California Irvine School of Medicine, Orange, CA 92868, USA;2. Divsion of Hematology-Oncology, Department of Medicine, University of California San Diego School of Medicine, La Jolla, CA 92307, USA;3. Comprehensive Cancer Centers of Nevada, Las Vegas, NV 89169, USA;4. University Cancer and Blood Center, Athens, GA 30607, USA;5. Foundation Medicine Inc., Cambridge, MA 02141, USA;6. Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY 12208, USA;1. Department of Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy;2. Department of Oncology, University of Turin, and Division of Medical Oncology, Ordine Mauriziano Hospital, Turin, Italy;3. Department of Pathology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy |
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| Abstract: | ObjectiveSeveral guidelines recommend erlotinib, pemetrexed, or docetaxel for second-line chemotherapy in patients with advanced non-squamous non-small-cell lung cancer (NSCLC). The aim of this study was to retrospectively evaluate the efficacy of erlotinib, pemetrexed, and docetaxel in epidermal growth factor receptor (EGFR) mutation-negative patients with previously treated advanced non-squamous NSCLC.Materials and methodsWe analyzed the efficacy of these agents in patients with previously treated advanced non-squamous NSCLC who had EGFR wild-type tumors, performance status (PS) of 0, 1, or 2 and received erlotinib, pemetrexed, or docetaxel between December 2007 and September 2011. Variability among patient backgrounds was evaluated using propensity scores to assess comparability. The efficacy of these agents was evaluated in patient subgroups with low variability.ResultsThe propensity scores showed that the backgrounds of the groups that received second-line therapy with each agent had low variability and were adequate for comparison. Patients were divided into the PS0/1 and PS2 groups for analysis. The median progression-free survival (PFS) in patients treated with erlotinib was 2.8 months in the PS0/1 group, as compared with 1.0 month in the PS0/1/2 group and 0.90 months in the PS2 group. PFS in PS0/1 patients who received erlotinib was comparable to that in PS0/1 patients who received pemetrexed (2.5 months) or docetaxel (1.9 months). Overall survival (OS) in erlotinib-, pemetrexed-, and docetaxel-treated PS0/1 patients was 16.1, 7.4 and 10.0 months, respectively. The study had limited power to detect differences in PFS and OS because of the small sample size.ConclusionsErlotinib appears to be a useful second-line option in PS0/1 patients with EGFR mutation-negative advanced non-squamous NSCLC given its mild adverse effects. The results should be carefully interpreted because of the small sample size, limited power, and retrospective nature of the study. |
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| Keywords: | Non-squamous non-small-cell lung cancer Erlotinib Pemetrexed Docetaxel Performance status Second-line treatment |
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