Pemetrexed versus erlotinib in pretreated patients with advanced non–small cell lung cancer: A Hellenic Oncology Research Group (HORG) randomized phase 3 study
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- Athanasios Karampeazis
- Medical Oncology Unit 417 NIMTS Veterans Hospital Athens Greece
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- Alexandra Voutsina
- Laboratory of Tumor Cell Biology University of Crete Heraklion Crete
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- John Souglakos
- Laboratory of Tumor Cell Biology University of Crete Heraklion Crete
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- Nikos Kentepozidis
- Department of Medical Oncology 251 Air Force Hospital Athens Greece
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- Stelios Giassas
- Department of Medical Oncology IASO General Hospital Athens Greece
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- Charalambos Christofillakis
- Department of Medical Oncology 401 Military Hospital of Athens Athens Greece
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- Athanasios Kotsakis
- Laboratory of Tumor Cell Biology University of Crete Heraklion Crete
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- Pavlos Papakotoulas
- Second Department of Medical Oncology Theagenion Anticancer Hospital of Thessaloniki Thessaloniki Greece
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- Ageliki Rapti
- Sotiria Chest Diseases Hospital 8th Pulmonary Clinic Athens Greece
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- Maria Agelidou
- Department of Pulmonary Diseases Sismanoglion General Hospital of Athens Athens Greece
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- Sofia Agelaki
- Laboratory of Tumor Cell Biology University of Crete Heraklion Crete
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- Lambros Vamvakas
- Department of Medical Oncology University General Hospital of Heraklion Heraklion Crete
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- George Samonis
- Department of Internal Medicine University General Hospital of Heraklion University of Crete Heraklion Crete
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- Dimitris Mavroudis
- Laboratory of Tumor Cell Biology University of Crete Heraklion Crete
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- Vassilis Georgoulias
- Laboratory of Tumor Cell Biology University of Crete Heraklion Crete
抄録
<jats:sec><jats:title>BACKGROUND</jats:title><jats:p>In this superiority study, pemetrexed was compared with erlotinib in pre‐treated patients with metastatic non–small cell lung cancer (NSCLC).</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>Patients with stage IIIB/IV NSCLC who progressed after first‐line or second‐line treatment were randomized to receive either pemetrexed or erlotinib. In total, 21.7% of patients in the pemetrexed arm and 23.5% of patients in the erlotinib arm had squamous cell histology, and treatment was third line in 39.2% and 46.4% of patients, respectively. The primary study endpoint was time to tumor progression (TTP). Epidermal growth factor receptor/v‐Ki‐<jats:italic>ras</jats:italic>2 Kirsten rat sarcoma viral oncogene homolog (<jats:italic>EGFR</jats:italic>/<jats:italic>KRAS</jats:italic>) mutation status also was investigated.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>There was no difference in terms of the TTP (<jats:italic>P</jats:italic> = .195), the objective response rate (<jats:italic>P</jats:italic> = .469), or overall survival (<jats:italic>P</jats:italic> = .986) between the 2 treatment arms. In patients who had squamous cell histology, erlotinib resulted in a superior TTP compared with pemetrexed (4.1 months vs 2.5 months, respectively; <jats:italic>P</jats:italic> = .006). The incidence of grade 3 and 4 neutropenia, thrombocytopenia, and asthenia was significantly higher in the pemetrexed arm, whereas the incidence of grade 3 and 4 skin rash was higher in the erlotinib arm.</jats:p></jats:sec><jats:sec><jats:title>CONCLUSIONS</jats:title><jats:p>Both pemetrexed and erlotinib had comparable efficacy in pre‐treated patients with metastatic NSCLC, and the current results indicated that genotyping of tumor cells may have an important effect on treatment efficacy. <jats:bold><jats:italic>Cancer</jats:italic> 2013</jats:bold>;119:2754–2764. © <jats:italic>2013 American Cancer Society</jats:italic>.</jats:p></jats:sec>
収録刊行物
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- Cancer
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Cancer 119 (15), 2754-2764, 2013-05-09
Wiley