Korean J Med.  2010 Oct;79(4):394-403.

Clinical outcomes of erlotinib, gefitinib, or pemetrexed in patients with non-squamous, non-small-cell lung cancer

• Yoon LY
• Yang MY
• Yun J
• Kim HJ
• Kim HJ
• Kim KH
• Kim SH
• Lee SC
• Kim CK
• Lee NS
• Park SK
• Lee KT
• Won JH
• Park HS
• Hong DS

Abstract

BACKGROUND/AIMS
This study compared the clinical benefits of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) with pemetrexed to identify the clinical parameters that correlated with response.
METHODS
A retrospective chart review examined patients who were 1) treated with EGFR TKI or pemetrexed, 2) diagnosed with advanced non-squamous non-small-cell lung cancer, and 3) previously treated with platinum-based chemotherapy in Soonchunhyang Bucheon Hospital.
RESULTS
Sixty-one patients (18 erlotinib, 18 gefitinib, 25 pemetrexed) were investigated from February 2002 to August 2009. The median follow-up period was 37 months (7~97 months). Overall, their median age was 63 years, 41 patients were non-smokers, 57 patients had adenocarcinoma, and 55 patients were at stage IV. Twenty-one patients received the study drugs as second-line chemotherapy, and others as third-line or more. No significant differences in the overall response rate (erlotinib 33.3% vs. gefitinib 38.9% vs. pemetrexed 20.0%) and progression-free survival (erlotinib 1.9 months vs. gefitinib 3.0 months vs. pemetrexed 2.9 months) were found among the three groups. Female gender was related to a good response to EGFR TKIs (p=0.047). Skin rash in the erlotinib group (p=0.037) and adenocarcinoma in the pemetrexed group (p=0.02) were related to improved progression-free survival. Few side effects were reported.
CONCLUSIONS
Both EGFR TKIs and pemetrexed therapy for non-squamous non-small-cell lung cancer were efficient and tolerable after the failure of first-line platinum-based chemotherapy. Further prospective studies are needed to validate the predictive role of the suggested clinical parameters in this study.

Keyword

Carcinoma; Non-small-cell lung cancer; Erlotinib; Gefitinib; Pemetrexed

MeSH Terms

Adenocarcinoma
Disease-Free Survival
Exanthema
Female
Follow-Up Studies
Glutamates
Guanine
Humans
Lung
Lung Neoplasms
Protein-Tyrosine Kinases
Quinazolines
Receptor, Epidermal Growth Factor
Retrospective Studies
Erlotinib Hydrochloride
Pemetrexed
Glutamates
Guanine
Protein-Tyrosine Kinases
Quinazolines
Receptor, Epidermal Growth Factor