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The relationship between response to previous systemic treatment and the efficacy of subsequent pemetrexed therapy in advanced non-small cell lung cancer

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Authors
Sun, Jong-Mu; Oh, Do-Youn; Lee, Se-Hoon; Kim, Dong-Wan; Im, Seock-Ah; Kim, Tae-You; Lee, Jong Seok; Kim, Young-Whan; Heo, Dae Seog; Bang, Yung-Jue
Issue Date
2010-06
Citation
Lung Cancer, Vol.68 No.3, pp.427-432
Keywords
Non-small cell lung cancerChemotherapyPemetrexedGemcitabine
Abstract
Background: We sought to identify the relationship between response to previous systemic treatment and the efficacy of subsequent pemetrexed therapy in advanced non-small cell lung cancer (NSCLC). Patients and methods: Two hundred and fifty clinical stage IIIB or IV NSCLC patients treated with pemetrexed as a second-line or further-line treatment between April 2007 and June 2008 were analyzed retrospectively. Prior therapies were divided into four types (gemcitabine-based [G], paclitaxel-based [P] docetaxel-based [D], and EGFR tyrosine kinase inhibitor [I]). Objective response rates (ORR) and progression-free survivals (PFS) for pemetrexed therapy were analyzed according to the response outcome with each previous treatment. Results: The ORR of pemetrexed therapy was higher for patients who had achieved partial response with previous [G] therapy than others (15.0% vs. 4.3%, p = 0.02). In addition, median PFS for pemetrexed therapy was greater for responders to [G] than for nonresponders (3.0 months vs. 1.7 months, p = 0.004). The longer PFS for responders to [G] was also shown in the analysis among patients with squamous cell carcinoma (3.2 months vs. 1.7 months, p = 0.056). By univariate analyses, the variables of the responder to [G] therapy, female, adenocarcinoma, never smoking status, and ECOG performance status of 0-1 were good predictive factors for pemetrexed therapy in terms of PFS. Multivariate analysis revealed that only response to [G] had statistical significance (hazard ratio = 0.62, p = 0.006). Conclusion: Response outcome to prior [G] therapy might predict the efficacy of subsequent pemetrexed therapy in advanced NSCLC. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
ISSN
0169-5002
URI
https://hdl.handle.net/10371/165542
DOI
https://doi.org/10.1016/j.lungcan.2009.07.013
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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