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.