China Oncology ›› 2017, Vol. 27 ›› Issue (2): 135-139.doi: 10.19401/j.cnki.1007-3639.2017.02.009

Previous Articles     Next Articles

Pemetrexed with gefitinib or pemetrexed alone in advanced non-small cell lung cancer with acquired resistance to EGFR tyrosine kinase inhibitors

LIU Hongliu, YANG Jiamei   

  1. Department of Oncology, the Second Affiliated Hospital of Zhengzhou University, Zhengzhou 450000, Henan Province, China
  • Online:2017-02-28 Published:2017-03-22
  • Contact: YANG Jiamei E-mail: yxxlvip@sina.com

Abstract: Background and purpose: New treatment methods should be explored for non-small cell lung cancer (NSCLC) patients with acquired resistance to epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI). This study compared the curative effect of pemetrexed with gefitinib or pemetrexed alone in advanced NSCLC with acquired resistance to EGFR-TKI. Methods: This study included 62 NSCLC patients with advanced EGFR gene mutation and acquired resistance to EGFR-TKI. Among those, 32 patients were treated with pemetrexed and gefitinib, and 30 patients treated with gefitinib alone. The differences in outcomes between the two strategies were assessed. Results: Objective response rate (ORR) was 46.9% for those treated with pemetrexed and gefitinib and 20% for those treated with pemetrexed alone(χ2=4.933, P<0.05). There was no significant differences between the two groups on disease control rate (DCR) (P>0.05). The median progression-free survival (PFS) was 8.0 months on pemetrexed and gefitinib group and 6.3 months on pemetrexed alone (χ2=8.063, P<0.05). There was no significant differences between the two groups on overall survival (OS) (P>0.05). Higher occurrence of leukocytopenia and rash was observed in the pemetrexed and gefitinib group than in the pemetrexed group (P<0.05). There was no significant differences between the two groups on grade 3-4 toxicities (P>0.05). Conclusion: This study was to demonstrate that continuation of EGFR-TKI with pemetrexed in patients with acquired resistance improves outcomes compared with pemetrexed alone. An improved response rate and PFS were observed in this study. A larger prospective clinical trial is needed to  further evaluate this promising strategy.

Key words: Pemetrexed, Gefitinib, Advanced non-small cell lung cancer, Epidermal growth factor receptor-tyrosine kinase inhibitor