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Gefitinib Versus Pemetrexed as Second-Line Treatment in Patients With Nonsmall Cell Lung Cancer Previously Treated With Platinum-Based Chemotherapy

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Affiliated Author(s)
송홍석
Alternative Author(s)
Song, Hong Suk
Journal Title
Cancer
ISSN
0008-543X
Issued Date
2012
Abstract
BACKGROUND:Gefitinib was compared with pemetrexed as second-line therapy in a clinically selected population previously treated with platinum-based chemotherapy. METHODS: A phase 3 trial of gefitinib (250 mg/day) versus pemetrexed (500 mg/m2 on day 1, every 3 weeks) was conducted in patients who had never smoked and who had advanced pulmonary adenocarcinoma treated with 1 previous platinum-based regimen. The primary endpoint was progression-free survival (PFS). RESULTS: A total of 135 patients were analyzed. The gefitinib group had significantly longer PFS compared with the pemetrexed group, with a median PFS time of 9.0 versus 3.0 months (P = .0006). The objective response rates were 58.8% and 22.4% for gefitinib and pemetrexed, respectively (P < .001). However, there was no statistically significant difference in overall survival between the 2 groups (22.2 vs 18.9 months; P = .37). The difference of PFS was increased in a subgroup analysis of 33 patients with activating epidermal growth factor receptor mutation (15.7 vs 2.9 months; hazard ratio, 0.3; 95% confidence interval, 0.13-0.72; P = .005), with numerical superiority of gefitinib in the 38 patients testing negative for epidermal growth factor receptor mutation (5.9 vs 2.7 months; P = .099). Both regimens were well tolerated. There were no significantly different changes in quality of life between the 2 groups, except that symptom scores for dyspnea and diarrhea favored the gefitinib and pemetrexed arms, respectively. CONCLUSIONS: Gefitinib showed superior efficacy to pemetrexed as second-line therapy in Korean never-smokers with pulmonary adenocarcinoma.
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
Jong-Mu Sun et al. (2012). Gefitinib Versus Pemetrexed as Second-Line Treatment in Patients With Nonsmall Cell Lung Cancer Previously Treated With Platinum-Based Chemotherapy. Cancer, 118(24), 6234–6242. doi: 10.1002/cncr.27630
Type
Article
ISSN
0008-543X
DOI
10.1002/cncr.27630
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/35278
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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