Jia Bo, He Xiao-hui, Yang Sheng, Wang Zi-ping, Li Jun-ling, Wang Yan, Wang Hong-yu, Xing Pu-yuan, Liu Yu-tao, Shi Yuan-kai
Department of Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China? Email:
Zhonghua Yi Xue Za Zhi. 2013 Dec;93(46):3659-62.
To explore the association between different epidermal growth factor receptor (EGFR) mutation status and survival in pemetrexed-based chemotherapy for advanced non-small-cell lung cancer (NSCLC).
A retrospective cohort study was performed to assess 146 patients with advanced NSCLC at Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College. The first-line regimens included pemetrexed based chemotherapy (pemetrexed first-line therapy group, n = 79), pemetrexed based chemotherapy plus pemetrexed maintenance chemotherapy (pemetrexed maintenance therapy group, n = 38) and pemetrexed based chemotherapy plus tyrosine kinase inhibitors (TKI) maintenance therapy (TKI maintenance therapy group, n = 29). Median progression-free survival (PFS) was determined.For comparison, median PFS was evaluated for EGFR-positive,EGFR-negative versus EGFR mutation unknown NSCLC patients in first-line pemetrexed therapy and pemetrexed maintenance therapy groups.
The median PFS was 4.6 (95%CI: 2.8-6.4), 9.8 (95%CI: 6.1-13.5) and 14.5 (95%CI: 11.8-17.2) months in pemetrexed first-line therapy, pemetrexed maintenance therapy and TKI maintenance therapy groups respectively (P = 0.000). No difference existed in PFS for pemetrexed first-line therapy group with a median PFS of 5.2 (95%CI: 2.8-7.7), 4.0 (95%CI: 0-10.8) and 4.6 (95%CI: 3.4-5.8) months respectively (P = 0.661). Among EGFR-positive,EGFR-negative and EGFR mutation status unknown patients in pemetrexed maintenance therapy group, the median PFS was 8.5 (95%CI: 4.0-13.1), 12.6 (95%CI: 11.6-13.7) and 8.0 (95%CI: 5.8-10.3) months with no significant statistical difference (P = 0.468).
No significant difference exists in survival between different EGFR mutation status for pemetrexed based first-line chemotherapy. And TKI maintenance therapy is associated with better survival than pemetrexed maintenance therapy regardless of EGFR status.
探讨在以培美曲塞为基础的晚期非小细胞肺癌（NSCLC）化疗中，不同表皮生长因子受体（EGFR）突变状态与生存之间的关联。
进行一项回顾性队列研究，评估中国医学科学院肿瘤医院和北京协和医学院的146例晚期NSCLC患者。一线治疗方案包括以培美曲塞为基础的化疗（培美曲塞一线治疗组，n = 79）、以培美曲塞为基础的化疗加培美曲塞维持化疗（培美曲塞维持治疗组，n = 38）和以培美曲塞为基础的化疗加酪氨酸激酶抑制剂（TKI）维持治疗（TKI维持治疗组，n = 29）。确定中位无进展生存期（PFS）。为作比较，评估一线培美曲塞治疗组和培美曲塞维持治疗组中EGFR阳性、EGFR阴性及EGFR突变状态未知的NSCLC患者的中位PFS。
培美曲塞一线治疗组、培美曲塞维持治疗组和TKI维持治疗组的中位PFS分别为4.6（95%CI：2.8 - 6.4）、9.8（95%CI：6.1 - 13.5）和14.5（95%CI：11.8 - 17.2）个月（P = 0.000）。培美曲塞一线治疗组中，EGFR阳性、EGFR阴性及EGFR突变状态未知患者的PFS分别为5.2（95%CI：2.8 - 7.7）、4.0（95%CI：0 - 10.8）和4.6（95%CI：3.4 - 5.8）个月，差异无统计学意义（P = 0.661）。培美曲塞维持治疗组中，EGFR阳性、EGFR阴性及EGFR突变状态未知患者的中位PFS分别为8.5（95%CI：4.0 - 13.1）、12.6（9C5%CI：11.6 - 13.7）和8.0（95%CI：5.8 - 10.3）个月，无显著统计学差异（P = 0.468）。
在以培美曲塞为基础的一线化疗中，不同EGFR突变状态的患者生存无显著差异。无论EGFR状态如何，TKI维持治疗比培美曲塞维持治疗的生存情况更好。
