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Pemetrexed versus Gefitinib versus Erlotinib in previously treated patients with non-small cell lung cancer

Authors
Hong, JunshikKyung, Sun YoungLee, Sang PyoPark, Jeong WoongJung, Sung HwanLee, Jae-IkPark, Se HoonSym, Sun JinPark, JinnyCho, Eun KyungShin, Dong BokLee, Jae Hoon
Issue Date
Sep-2010
Publisher
대한내과학회
Keywords
Erlotinib; Gefitinib; Lung neoplasms; Pemetrexed
Citation
The Korean Journal of Internal Medicine, v.25, no.3, pp 294 - 300
Pages
7
Indexed
SCOPUS
KCI
Journal Title
The Korean Journal of Internal Medicine
Volume
25
Number
3
Start Page
294
End Page
300
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65739
DOI
10.3904/kjim.2010.25.3.294
ISSN
1226-3303
2005-6648
Abstract
Background/Aims: The efficacy and safety of pemetrexed, gefitinib, and erlotinib administration in previously treated patients with non-small cell lung cancer (NSCLC) were compared. Methods: The study patients met the following criteria: histologically confirmed, previously treated advanced (stage IIIB or IV) or recurrent NSCLC; a measurable lesion; ≥ 18 years of age; Eastern Cooperative Oncology Group Performance status 0 to 2; and no prior exposure to the three study drugs. Patients received 500 mg/m2 of pemetrexed intravenously every 3 weeks with vitamin supplementation, gefitinib (250 mg/day per os), or erlotinib (150 mg/day per os). Results: Of 57 patients (pemetrexed, 20; gefitinib, 20; and erlotinib, 17), 55 were evaluated for a response. The numbers of males, smokers, and squamous histology were increased in the pemetrexed group compared to the other groups. The objective response rates were 5.3%, 25.0%, and 12.5% (p = 0.22), and the disease control rates (DCR) were 5.3%, 40.0%, and 50.0%, respectively (p < 0.01). The median progression-free survival (PFS) was 1.7, 3.5, and 4.4 months (p < 0.01) and the median overall survival (OS) was 5.6, 21.8, and 21.5 months (p = 0.04), respectively. In subgroup analyses, patients with non-squamous histology, males, and a smoking history had a higher DCR and longer PFS with gefitinib and erlotinib than with pemetrexed. All three chemotherapeutic agents had manageable toxicities. Conclusions: Both oral epidermal growth factor receptor tyrosine kinase inhibitors (EGFR TKIs) had comparable efficacy and safety. The superior PFS and OS of EGFR TKIs with more favorable baseline clinical characteristics than those of pemetrexed suggest the impact of baseline clinicopathological factors.
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Park, Jinny
Ansan Hospital (Department of Medical Oncology and Hematology, Ansan Hospital)
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