Predictive factors for a long-term response duration in non-squamous cell lung cancer patients treated with pemetrexed

BMC Cancer

Research Article

Jin Kyung Rho¹  Hyun Jung Kim²  Jae Cheol Lee³  Sang–We Kim³  Dae Ho Lee³  Jung–Shin Lee³  Sojung Park⁴  Woo Sung Kim⁴  Chang–Min Choi⁵  Se Hoon Choi⁶ 

[1] Asan Institute for Life Sciences, Asan Medical Center, 388-1 Pungnap–Dong, Songpa-gu, 05505, Seoul, South Korea;Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, 130 Dongdeok-ro, Jung-gu, 41944, Daegu, South Korea;Department of Oncology, University of Ulsan, College of Medicine, Asan Medical Center, 388-1 Pungnap–Dong, Songpa-gu, 05505, Seoul, South Korea;Department of Pulmonary and Critical Care Medicine, University of Ulsan, College of Medicine, Asan Medical Center, 388-1 Pungnap–Dong, Songpa-gu, 05505, Seoul, South Korea;Department of Pulmonary and Critical Care Medicine, University of Ulsan, College of Medicine, Asan Medical Center, 388-1 Pungnap–Dong, Songpa-gu, 05505, Seoul, South Korea;Department of Oncology, University of Ulsan, College of Medicine, Asan Medical Center, 388-1 Pungnap–Dong, Songpa-gu, 05505, Seoul, South Korea;Department of Thoracic and Cardiovascular Surgery, University of Ulsan, College of Medicine, Asan Medical Center, 388-1 Pungnap–Dong, Songpa-gu, 05505, Seoul, South Korea;

关键词: Pemetrexed;    Non-small-cell lung cancer;    Prognosis;    Progression-free survival;    EGFR;    Anaplastic lymphoma kinase;   

DOI  :  10.1186/s12885-016-2457-0

 received in 2015-11-03, accepted in 2016-06-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundPemetrexed is widely used for the treatment of advanced non-squamous non-small-cell lung cancer (NSCLC). However, factors that can predict the benefits of pemetrexed therapy have not yet been defined.MethodsWe compared the clinical and molecule pathological characteristics of good and poor responders among a cohort of 1,848 non-squamous NSCLC patients who had received at least two cycles of pemetrexed therapy between November 2006 and February 2015. Among these cases, 92 good responders who were the top 5 % in terms of progression-free survival (PFS) and 222 poor responders who had progressive disease after only 2 cycles of therapy were selected for the analysis.ResultsThe median PFS of the good responders was 29.9 months (range; 20.9–90.0) and the median number of cycle was 37 (range; 18–129). Although 53.5 % of patients showed stable disease (SD), this response was sustained (median PFS in SD, 29.6 months). A never-smoking status was related to better survival outcome, whereas EGFR mutation, two or more metastatic sites, and intra-abdominal metastasis were each associated with a poor PFS. ALK translocation showed a tendency for a positive impact on response to pemetrexed, whereas metastatic lesion to liver, adrenal gland or bone showed a tendency for a negative impact despite not reaching our threshold for statistical significance.ConclusionsPredictive factors, such as smoking status, the status of genetic alteration and tumor burden, should be considered when administering pemetrexed therapy for non-squamous NSCLC.

【 授权许可】

CC BY   
© The Author(s). 2016