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International Journal of Clinical Oncology

Erschienen in:

20.06.2022 | Original Article

Survival benefit of using pemetrexed for EGFR mutation-positive advanced non-small-cell lung cancer in a randomized phase III study comparing gefitinib to cisplatin plus docetaxel (WJTOG3405)

verfasst von: Naoki Haratake, Mototsugu Shimokawa, Takashi Seto, Hiroshige Yoshioka, Nobuyuki Yamamoto, Kazuhiko Nakagawa, Tetsuya Mitsudomi

Erschienen in: International Journal of Clinical Oncology | Ausgabe 9/2022

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Abstract

Background

Pemetrexed is common cytotoxic chemotherapy among non-squamous non-small cell lung cancer (non-Sq-NSCLC) patients; however, among epidermal growth factor receptor (EGFR)-positive lung cancer, there is no clear evidence to support the efficacy of sequential treatment with pemetrexed.

Material and methods

We performed a post-hoc analysis of subsequent chemotherapies among 144 patients who received the post-protocol treatment in the phase III trial WJTOG 3405 comparing gefitinib to cisplatin plus docetaxel, and analyzed the effect of pemetrexed on overall survival (OS).

Results

Patients with treatment including pemetrexed exhibited significantly longer OS in comparison to those without pemetrexed; the median OS in the pemetrexed + and pemetrexed– patients were 40.7 months and 28.0 months, respectively (0.55 of HR [95% CI: 0.38–0.80, p = 0.0020]). On the other hand, other treatments, including docetaxel, TS-1 and paclitaxel showed no significant impact on OS. The multivariate analysis with a time-dependent Cox proportional hazards model showed that treatment including pemetrexed, as well as PS 0 and post-operative recurrence, were independent predictors of a good prognosis. Moreover, among patients who received at least four lines of prior treatment, pemetrexed + treatment also significantly prolonged OS in comparison to pemetrexed– treatment (median OS pemetrexed + vs. pemetrexed–: 44.4 months vs. 32.6 months; HR: 0.55 [95% CI: 0.31–0.94, p = 0.0290]).

Conclusions

Sequential treatment including pemetrexed against EGFR-mutated NSCLC might be associated with a better outcome. It was considered that pemetrexed should be administered without fail as a sequential treatment to improve the prognosis of EGFR-mutated NSCLC as well as like EGFR-tyrosine kinase inhibitors.

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Titel: Survival benefit of using pemetrexed for EGFR mutation-positive advanced non-small-cell lung cancer in a randomized phase III study comparing gefitinib to cisplatin plus docetaxel (WJTOG3405)
verfasst von: Naoki Haratake
Mototsugu Shimokawa
Takashi Seto
Hiroshige Yoshioka
Nobuyuki Yamamoto
Kazuhiko Nakagawa
Tetsuya Mitsudomi
Publikationsdatum: 20.06.2022
Verlag: Springer Nature Singapore
Erschienen in: International Journal of Clinical Oncology / Ausgabe 9/2022
Print ISSN: 1341-9625
Elektronische ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-022-02193-x

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24.04.2024 | DGIM 2024 | Nachrichten

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Survival benefit of using pemetrexed for EGFR mutation-positive advanced non-small-cell lung cancer in a randomized phase III study comparing gefitinib to cisplatin plus docetaxel (WJTOG3405)

Abstract

Background

Material and methods

Results

Conclusions

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Bei Senioren mit Prostatakarzinom auf Anämie achten!

ICI-Therapie in der Schwangerschaft wird gut toleriert

Krebspatienten impfen: Was? Wen? Und wann nicht?

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Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Background

Material and methods

Results

Conclusions

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