Chinese Journal of Lung Cancer (Oct 2013)

Efficacy of Chemotherapy after EGFR-TKIs Resistance in 191 Patients with Unknow EGFR Gene Mutation in Advanced Lung Adenocarcinoma

  • Ping HE,
  • Yan WANG,
  • Sheng YANG,
  • Shufei YU,
  • Ziping WANG,
  • Junling LI,
  • Bin WANG,
  • Xuezhi HAO,
  • Hongyu WANG,
  • Xingsheng HU,
  • Xiangru ZHANG,
  • Yuankai SHI

DOI
https://doi.org/10.3779/j.issn.1009-3419.2013.10.06
Journal volume & issue
Vol. 16, no. 10
pp. 529 – 534

Abstract

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Background and objective Subsequent chemotherapy were needed in patients with advanced pulmonary adenocarcinoma experiencing disease progression after epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) treatment. The study is to explore factors potentially influencing efficacy of subsequent chemotherapy. Methods One hundred and ninety-one patients with advanced lung adenocarcinoma, who were resistant from EGFR-TKIs and then received subsequent chemotherapy, were identified. Data of patient’s characteristics, responses to chemotherapy and survival time were analyzed retrospectively. Results The overall response rate of the pemetrexed-based chemotherapy (9.3%) was higher than non-pemetrexed-based regimen (1.1%), P=0.011. Furthermore, the response in the second-line was more obvisous [objective response rate (ORR) 14.3% vs 3.7%, P=0.041]. The patients who achieved response of partial response (PR) showed longer progression-free survival (PFS) than those who achieved non-PR (PFS 10.1 months and 2.3 months, P=0.012). The patients treated with platinum-based chemotherapy had longer PFS and OS than those with non-platinum-based chemotherapy, therefore platinum-based regimen was independent prognosis factors for PFS and OS (PFS: RR=0.634, 95%CI: 0.466-0.832, P=0.004; OS: RR=0.666, 95%CI: 0.460-0.960, P=0.030), especially the pateients who were aquired EGFR-TKIs resistance and who got drmatic progression from EGFR-TKIs treatment might got more benefits from platinum-based chemotherapy. However there was no significant difference in ORR, PFS or OS between patients with TKIs primary resistance and acquired resistance, or between dramtic progression and gradual/local progression. Conclusion The patients with advanced lung adenocarcinoma might get benefits from pemetrexed-based or platinum-based chemotherapy after they were EGFR-TKIs resistace.

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