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Endobronchial Ultrasound-guided Intratumoral Injection of Cisplatin for the Treatment of Isolated Mediastinal Recurrence of Lung Cancer
Published on: February 12, 2017
Pemetrexed plus platinum versus pemetrexed alone in non-small cell lung cancer patients who have progressed after
Su Jin Lee1, Jong-Mu Sun1, Se Hoon Lee1
1Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Objectives:
After failure of first-line epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) in patients with non-small cell lung cancer (NSCLC) harboring EGFR-activating mutation, platinum based combination chemotherapy is recommended. However, it is still unknown which chemotherapeutic regimens result in better outcomes.
Materials And Methods:
A total of 63 patients who were treated with pemetrexed or pemetrexed/platinum chemotherapy after first line EGFR TKI therapy at Samsung Medical Center were included in our analysis. Baseline clinical characteristics, response rate, toxicities and survival outcomes were compared between the two groups.
Results:
Among 63 patients, 29 were treated with pemetrexed (P) alone and 34 were treated with pemetrexed and platinum combination (PC) therapy. The median age, sex and smoking history was not different between the two groups. The overall response rate and disease control rate was 25.9%/44.4% for the P group and 43.5%/75.0% for the PC group (p = 0.154 in response rate, p = 0.017 in disease control rate). Grade 2 or 3 neutropenia was noted only for the PC group (0% vs. 18.8%, p = 0.049). For progression-free survival (PFS), patients treated with PC had more favorable outcomes than patients treated with P alone, although the difference was not statistically significant (5.2 vs. 2.7 months, PC vs. P; p=0.096).
Conclusions:
Based on this retrospective analysis, platinum combination with pemetrexed resulted in a better disease control rate and a tendency toward prolongation of progression-free survival in NSCLC patients who progressed after first-line EGFR TKIs.
Insights
Platinum combination chemotherapy with pemetrexed improved disease control and showed a trend towards longer progression-free survival in non-small cell lung cancer (NSCLC) patients after EGFR TKI failure. This finding offers valuable insights for treatment selection in advanced NSCLC.
Area of Science:
- Oncology
- Medical Oncology
- Pharmacology
Background:
- First-line epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) are standard for EGFR-mutated non-small cell lung cancer (NSCLC).
- Limited data exists on optimal chemotherapy regimens following EGFR TKI failure.
Purpose of the Study:
- To compare the efficacy and safety of pemetrexed alone versus pemetrexed/platinum combination chemotherapy in NSCLC patients after first-line EGFR TKI failure.
- To identify chemotherapy regimens that improve outcomes in this patient population.
Main Methods:
- Retrospective analysis of 63 NSCLC patients treated with pemetrexed or pemetrexed/platinum post-first-line EGFR TKI.
- Comparison of baseline characteristics, response rates, toxicities, and survival outcomes between treatment groups.
Main Results:
- The pemetrexed/platinum group showed a significantly higher disease control rate (75.0% vs. 44.4%, p=0.017).
- The pemetrexed/platinum group experienced more Grade 2/3 neutropenia (18.8% vs. 0%, p=0.049).
- Progression-free survival (PFS) was longer in the pemetrexed/platinum group (5.2 vs. 2.7 months), though not statistically significant (p=0.096).
Conclusions:
- Platinum combination with pemetrexed demonstrates superior disease control in NSCLC patients progressing after first-line EGFR TKIs.
- This combination therapy shows a trend towards improved progression-free survival.
- Pemetrexed/platinum chemotherapy is a viable option for NSCLC patients post-EGFR TKI failure, balancing efficacy and toxicity.
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