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Clinical outcomes of erlotinib, gefitinib, or pemetrexed in patients with non-squamous, non-small-cell lung cancer  

Yoon, La-Young (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Yang, Mi-Yean (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Yun, Jin-A (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Kim, Hyun-Jung (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Kim, Han-Jo (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Kim, Kyung-Ha (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Kim, Se-Hyung (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Lee, Sang-Cheol (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Kim, Chan-Kyu (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Lee, Nam-Su (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Park, Sung-Kyu (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Lee, Kyu-Taek (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Won, Jong-Ho (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Park, Hee-Sook (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Hong, Dae-Sik (Department of Internal Medicine, Division of Hematology and Oncology, Soonchunhyang University College of Medicine)
Publication Information
The Korean Journal of Medicine / v.79, no.4, 2010 , pp. 394-403 More about this Journal
Abstract
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.
Keywords
Carcinoma; Non-small-cell lung cancer; Erlotinib; Gefitinib; Pemetrexed;
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