Tumor response and clinical toxicity associated with second‐line chemotherapy regimens for advanced non‐squamous non‐small cell lung cancer: A retrospective cohort study

Thoracic Cancer

Chengping Hu⁷  Yan Wang⁵  Jianhua Chen⁶  Shengqi Wu³  Xiaoling Li¹  Yuqin Wang¹  Yicheng Yang²  Narayan Rajan⁴  Manny Papadimitropoulos⁴  Qiong Xiao⁸  Huan Zhan⁸ 

[1] Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Beijing, China;ORCID:orcid.org/0000-0003-4267-3783;Department of Research and Education, Hunan Province Tumor Hospital, Central South University, Changsha, China;Global Health Outcomes Research, Eli Lilly, Indianapolis, Indiana, USA;Department of Medical Oncology, Cancer Institute (Hospital), Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;Department of Medical Oncology, Hunan Province Tumor Hospital, Central South University, Changsha, China;Department of Respiratory, Xiangya Hospital, Central South University, Changsha, China;Health Outcomes Research, Normin Health Changsha Representative Office, Changsha, China

关键词: Adenocarcinoma;    docetaxel;    pemetrexed;    platinum‐based doublet;    previously treated;   

DOI  :  10.1111/1759-7714.12102

来源: Wiley

【 摘 要 】

Abstract

Background

Previously reported superior tumor response of pemetrexed in the second-line setting for advanced non-squamous non-small cell lung cancer (advNS-NSCLC) has never been confirmed in real-world studies. Platinum-based doublet is frequently used in the second-line setting for advanced NSCLC in China.

Methods

A retrospective cohort study was conducted including patients receiving pemetrexed or docetaxel-based chemotherapy in the second-line setting for advNS-NSCLC in four Chinese tertiary care hospitals. Propensity score matched treatment groups were created for head-to-head comparisons on best tumor response and clinical toxicity. Multiple regression analyses were performed to rank the impact of the four regimens on the risks of tumor progression and hematological adverse events.

Results

Three hundred and eighty-four patients were included for creating matched treatment groups for pemetrexed versus platinum/pemetrexed (33 pairs), docetaxel (17 pairs), and platinum/docetaxel (29 pairs), respectively. No significant differences were identified for best tumor response between pemetrexed and the other three regimens. However, pemetrexed was associated with significantly fewer patients experiencing anemia (39.4% vs. 69.7%, P = 0.004) and neutropenia (6.1% vs. 30.3%, P = 0.021) than platinum/pemetrexed. Multiple regression analyses indicated that pemetrexed was associated with significantly slower tumor progression (hazard ratio 0.628, P = 0.040) and a significantly lower risk of neutropenia (odds ratio 0.132, P = 0.019) than docetaxel.

Conclusions

Pemetrexed was associated with significantly postponed tumor progression and significantly less hematological toxicity than docetaxel in the real-world second-line setting for advNS-NSCLC in Chinese patients. Pemetrexed monotherapy had comparable tumor response, but significantly less hematological toxicity than pemetrexed-based doublet.

【 授权许可】

Unknown   
© 2014 Tianjin Lung Cancer Institute and Wiley Publishing Asia Pty Ltd