Efficacy of Second-Line Pemetrexed-Carboplatin in EGFR-Activating Mutation-Positive NSCLC: Does Exon 19 Deletion Differ from Exon 21 Mutation?

Chemotherapy research and practice Pub Date : 2017-01-01 Epub Date: 2017-10-23 DOI:10.1155/2017/8196434

Amit Joshi, Vanita Noronha, Vijay M Patil, Anuradha Chougule, Atanu Bhattacharjee, Rajiv Kumar, Supriya Goud, Sucheta More, Anant Ramaswamy, Ashay Karpe, Nikhil Pande, Arun Chandrasekharan, Alok Goel, Vikas Talreja, Abhishek Mahajan, Amit Janu, Nilendu Purandare, Kumar Prabhash

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引用次数: 1

Abstract

Background: It is unknown whether the outcomes of second-line pemetrexed-carboplatin chemotherapy administered after progression on gefitinib are dependent on type of EGFR mutation present at baseline.

Method: Adult non-small-cell lung cancer patients, with exon 19 deletion or exon 21 L858R mutation, who progressed on gefitinib and received pemetrexed-carboplatin chemotherapy were selected for this analysis.

Result: 55 patients received pemetrexed-carboplatin as second-line treatment. Response rates in evaluable patients were 39.3% in exon 19 patients (n = 28) and 33.3% in exon 21 patients (n = 15) (p = 0.752, Fisher's exact 2-sided p value). The median PFS in exon 19 and 21 cohorts was 5.900 months (95% CI: 4.274-7.526) and 4.767 months (95% CI: 1.374-8.159), respectively. The median overall survival in exon 19 patients was (11.8 months, 95% CI: 9.916-13.684 months) significantly better than that seen in exon 21 mutation patients (6.2 months, 95% CI: 4.215-8.118 months, p = 0.024) on univariate analysis; however, on multivariate analysis, this association was not confirmed (HR = 0.361, 95% CI: 0.090-1.439, p = 0.149).

Conclusion: Exon 19 deletion has no impact on PFS and OS in EGFR-mutated patients treated with second-line pemetrexed-carboplatin.

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二线培美曲塞-卡铂治疗egfr激活突变阳性NSCLC的疗效:外显子19缺失与外显子21突变是否不同?

背景:尚不清楚吉非替尼进展后给予培美曲塞-卡铂二线化疗的结果是否依赖于基线时存在的EGFR突变类型。方法:选择外显子19缺失或外显子21 L858R突变的成人非小细胞肺癌患者，经吉非替尼治疗进展并接受培美曲塞-卡铂化疗。结果:55例患者接受培美曲塞卡铂作为二线治疗。在可评估的患者中，外显子19患者的缓解率为39.3% (n = 28)，外显子21患者的缓解率为33.3% (n = 15) (p = 0.752, Fisher精确双侧p值)。外显子19和21队列的中位PFS分别为5900个月(95% CI: 4.274-7.526)和4.767个月(95% CI: 1.374-8.159)。单因素分析外显子19患者的中位总生存期(11.8个月，95% CI: 9.916-13.684个月)显著优于外显子21突变患者(6.2个月，95% CI: 4.215-8.118个月，p = 0.024);然而，在多变量分析中，这种关联没有得到证实(HR = 0.361, 95% CI: 0.090-1.439, p = 0.149)。结论:外显子19缺失对二线培美曲塞卡铂治疗的egfr突变患者的PFS和OS没有影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Chemotherapy research and practice

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