Institute of Biomedical Sciences, National Chung-Hsing University, Taichung, Taiwan ; Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Division of Chest Medicine, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Onco Targets Ther. 2014 May 23;7:799-805. doi: 10.2147/OTT.S62639. eCollection 2014.
Tumor cells before and after epidermal growth-factor receptor (EGFR) tyrosine-kinase inhibitor (TKI) therapy might display different characteristics. The aim of this study was to evaluate the influence of prior EGFR TKI therapy on the efficacy of subsequent pemetrexed plus platinum (PP) in advanced chemonaïve patients with EGFR-mutant lung adenocarcinoma.
Advanced chemonaïve patients with EGFR-mutant lung adenocarcinoma receiving PP as first-line chemotherapy were enrolled retrospectively in two medical centers of Taiwan. The objective of this study was to compare objective response rate (ORR), disease-control rates (DCR), progression-free survival (PFS), and overall survival (OS) of PP in patients with and without prior EGFR TKI therapy.
In total, 105 patients were analyzed. Sixty-one patients (58.1%) had prior EGFR TKI therapy and used PP as second-line treatment. The other 44 patients (41.9%) received PP as first-line therapy. ORRs of PP in patients with and without prior EGFR TKI therapy were 24.6% and 38.6%, respectively (P=0.138). DCRs of the two groups were 62.3% and 65.9%, respectively (P=0.837). The median PFS (6.1 versus 6.1 months, P=0.639) and OS (34.4 versus 32.3 months, P=0.394) were comparable between the groups with and without prior EGFR TKI therapy. In a subgroup analysis of patients with prior EGFR TKI therapy, there was no significant association between the efficacy of first-line EGFR TKI and the outcome of subsequent PP therapy.
Our results suggested that prior EGFR TKI therapy would not influence the efficacy of subsequent PP therapy in advanced chemonaïve patients with EGFR-mutant lung adenocarcinoma.
表皮生长因子受体（EGFR）酪氨酸激酶抑制剂（TKI）治疗前后的肿瘤细胞可能表现出不同的特征。本研究旨在评估先前 EGFR TKI 治疗对初治 EGFR 突变型肺腺癌患者后续培美曲塞联合铂类（PP）化疗疗效的影响。
本研究回顾性纳入了在台湾两家医学中心接受 PP 作为一线化疗的初治 EGFR 突变型肺腺癌患者。本研究的目的是比较有和无先前 EGFR TKI 治疗的患者接受 PP 治疗的客观缓解率（ORR）、疾病控制率（DCR）、无进展生存期（PFS）和总生存期（OS）。
共分析了 105 例患者。61 例（58.1%）患者有先前 EGFR TKI 治疗史，并用 PP 作为二线治疗。另外 44 例（41.9%）患者接受 PP 作为一线治疗。有和无先前 EGFR TKI 治疗的患者接受 PP 治疗的 ORR 分别为 24.6%和 38.6%（P=0.138）。两组的 DCR 分别为 62.3%和 65.9%（P=0.837）。两组的中位 PFS（6.1 个月比 6.1 个月，P=0.639）和 OS（34.4 个月比 32.3 个月，P=0.394）无显著差异。在先前接受 EGFR TKI 治疗患者的亚组分析中，一线 EGFR TKI 的疗效与后续 PP 治疗的疗效之间无显著相关性。
本研究结果表明，先前 EGFR TKI 治疗不会影响初治 EGFR 突变型肺腺癌患者后续 PP 化疗的疗效。
