The Efficacy of Pemetrexed-Based Therapy in Advanced Lung Adenocarcinoma with Targetable Driver Mutation: A Real-Life Experience
Received Date : 19 Jun 2019
Accepted Date : 22 Nov 2019
Available Online : 10 Feb 2020
Burak BİLGİNa, Şebnem YÜCELa, Ülkü YILMAZb
aAtatürk Chest Disease and Chest Surgery Research and Training Hospital, Department of Medical Oncology, Ankara, Turkey
bAtatürk Chest Disease and Chest Surgery Research and Training Hospital, Department of Chest Disease, Ankara, Turkey
Doi: 10.37047/jos.2020-73476 - Article's Language: EN
J Oncol Sci. 2020;6(1):43-8
ABSTRACT
Objective: Lung adenocarcinoma is the most common subtype of non-small cell lung cancer, and also, approximately 25% of
lung adenocarcinoma patients have targetable driver mutations. Despite several novel therapeutic advances in the treatment of lung adenocarcinoma
with targetable driver mutations, chemotherapy still has an important role to play. In this study, we aimed to evaluate the realworld
efficacy of pemetrexed-based chemotherapy in lung adenocarcinoma with the targetable mutation. Material and Methods: The
advanced lung adenocarcinoma patients with targetable driver mutations who received pemetrexed-based chemotherapy between 2014 and
2018 were enrolled in this study, retrospectively. The patients were stratified according to mutation type and pemetrexed-line as pre or posttyrosine
kinase inhibitor (TKI). The primary outcome of our study was considered as progression-free survival (PFS). Results: A total of 265
patients with the targetable mutation were screened and only 60 were enrolled in the study. In the entire group, the median PFS was 7.81. Median
PFS was significantly higher in ALK-ROS1 positive subgroup than EGFR positive subgroup (p=0.001). The median PFS was higher in
patients who received pre-TKI treatment in the ALK-ROS1 subgroup (p=0.006). In EGFR positive patients, PFS was similar between pre or
post TKI groups (p=0.28). The overall response rate was 55%, 59.1%, and 52.6% in the entire group, ALK-ROS1 positive and EGFR positive
subgroup, respectively. Conclusion: We showed that pemetrexed-based therapy is still an important choice for the patients who progress
after targeted therapy and also for those who are not suitable for another targeted therapeutic agent.
Keywords: Lung cancer; pemetrexed; real-world; PFS