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Review
. 2018 Apr 12:11:2121-2129.
doi: 10.2147/OTT.S157370. eCollection 2018.

Efficacy of pemetrexed-based regimens in advanced non-small cell lung cancer patients with activating epidermal growth factor receptor mutations after tyrosine kinase inhibitor failure: a systematic review

BaoHui Han  1 , LuLu Yang  2 , Xin Wang  3 , LuanDi Yao  2
Affiliations
Review

Efficacy of pemetrexed-based regimens in advanced non-small cell lung cancer patients with activating epidermal growth factor receptor mutations after tyrosine kinase inhibitor failure: a systematic review

BaoHui Han et al. Onco Targets Ther. .

Abstract

Pemetrexed-based chemotherapy regimens (pem regimens) are the standard first-line treatment option in patients with non-squamous non-small cell lung cancer (NSCLC). The objective of this systematic review was to assess the efficacy of pemetrexed in the context of epidermal growth factor receptor (EGFR) mutation-positive NSCLC following the failure of EGFR-tyrosine kinase inhibitor (TKI) treatment. We searched biomedical literature databases (PubMed, EMBASE, and the Cochrane library) and conference proceedings for studies evaluating the efficacy of pemetrexed monotherapy or pemetrexed combined with platinum or any other chemotherapeutic agent in EGFR-mutation-positive NSCLC after EGFR-TKI failure. We extracted data of primary outcomes of interest (progression-free survival [PFS], overall survival [OS], and overall response rate [ORR]). The weighted median PFS, OS, and ORR were then calculated. Of 83 potentially relevant studies, eight (three randomized studies and five retrospective studies) were identified (involving 1,193 patients) and included in this systematic review, with 640 patients receiving pem regimens. The weighted median PFS, median OS, and ORR for patients treated with pem regimens were 5.09 months, 15.91 months, and 30.19%, respectively. Our systematic review results showed a favorable efficacy profile of pem regimens in NSCLC patients with EGFR mutation after EGFR-TKI failure.

Keywords: advanced non–small cell lung cancer; epidermal growth factor receptor; pemetrexed; tyrosine kinase inhibitor.

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Conflict of interest statement

Disclosure LLY, XW, and LDY are employees of Eli Lilly and Company. HBH was involved in the design and conduct of the systematic literature review, funded by Eli Lilly and Company. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart representing the selection process of clinical studies in the systematic review. Abbreviations: EGFR, epidermal growth factor receptor; N, number of studies; TKI, tyrosine kinase inhibitor.
See this image and copyright information in PMC

References

    1. Park S, Keam B, Kim SH, et al. Pemetrexed singlet versus nonpemetrexed-based platinum doublet as second-line chemotherapy after first- line epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor failure in non-small cell lung cancer patients with EGFR mutations. Cancer Res Treat. 2015;47(4):630–637. - PMC - PubMed
    1. Masuda T, Imai H, Kuwako T, et al. Efficacy of platinum combination chemotherapy after first-line gefitinib treatment in non-small cell lung cancer patients harboring sensitive EGFR mutations. Clin Transl Oncol. 2015;17(9):702–709. - PubMed
    1. Polanski J, Jankowska-Polanska B, Rosinczuk J, Chabowski M, Szymanska-Chabowska M. Quality of life of patients with lung cancer. Onco Targets Ther. 2016;9:1023–1028. - PMC - PubMed
    1. Ali A, Goffin JR, Arnold A, Ellis PM. Survival of patients with non- small-cell lung cancer after a diagnosis of brain metastases. Curr Oncol. 2013;20(4):e300–e306. - PMC - PubMed
    1. Lee SJ, Sun JM, Lee SH, Ahn JS, Park K, Ahn MJ. Pemetrexed plus platinum versus pemetrexed alone in non-small cell lung cancer patients who have progressed after first-line EGFR TKIs. Lung Cancer. 2015;90(2):261–266. - PubMed