Differential efficacy of cisplatin plus pemetrexed between L858R and Del-19 in advanced EGFR-mutant non-squamous non-small cell lung cancer
Abstract Background LUX-Lung 3 showed afatinib improved progression-free survival (PFS) compared with cisplatin plus pemetrexed in patients with epidermal growth factor receptor (EGFR) mutations. In this study, chemotherapy efficacy tended to differ between patients with Leu858Arg (L858R) point muta...
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| Format: | Article |
| Language: | English |
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BMC
2018-01-01
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| Series: | BMC Cancer |
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| Online Access: | http://link.springer.com/article/10.1186/s12885-017-3952-7 |
| _version_ | 1818760285569155072 |
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| author | Toshihiko Kaneda Hiroshige Yoshioka Motohiro Tamiya Akihiro Tamiya Akito Hata Asukaka Okada Takashi Niwa Takayuki Shiroyama Masaki Kanazu Tadashi Ishida Nobuyuki Katakami |
| author_facet | Toshihiko Kaneda Hiroshige Yoshioka Motohiro Tamiya Akihiro Tamiya Akito Hata Asukaka Okada Takashi Niwa Takayuki Shiroyama Masaki Kanazu Tadashi Ishida Nobuyuki Katakami |
| author_sort | Toshihiko Kaneda |
| collection | DOAJ |
| description | Abstract Background LUX-Lung 3 showed afatinib improved progression-free survival (PFS) compared with cisplatin plus pemetrexed in patients with epidermal growth factor receptor (EGFR) mutations. In this study, chemotherapy efficacy tended to differ between patients with Leu858Arg (L858R) point mutation and Exon 19 deletion (Del-19); PFS in L858R patients (8.1 months) was greater than in Del-19 patients (5.6 months). We investigated whether there is any difference in efficacy of cisplatin plus pemetrexed between Del-19 and L858R. Methods This study is a multicenter retrospective study. We reviewed medical records of patients who had received cisplatin plus pemetrexed as first line chemotherapy. Efficacies were evaluated between EGFR mutation status: Del-19 and L858R. Wild type cases were reference arm only, and not included in any statistical analysis. Results Among 304 patients, 78 (25.7%) harbored EGFR mutations: Del-19 (36/78 patients, 46.2%); and L858R (42/78, 53.8%). Median PFS of L858R group (9.4 months, 95% confidence interval [CI]: 7.0–12.6) was significantly longer than Del-19 group (5.5 months, 95% CI, 3.6–8.6) (p = 0.049). Response rate (RR) and OS presented no significant difference between L858R and Del-19. In multivariate analysis, EGFR mutation status (L858R versus Del-19) was the only significant factor for longer PFS (Hazard ratio [HR]: 0.78, 95% CI: 0.62–0.98) (p = 0.033). Conclusion Our study indicated better efficacy of cisplatin plus pemetrexed in L858R than in Del-19 patients. In EGFR-mutant NSCLC, EGFR-TKIs are undoubtedly the premier therapy. However, in second line or later settings, cisplatin plus pemetrexed regimen may confer higher efficacy for L858R patients. |
| first_indexed | 2024-12-18T06:56:12Z |
| format | Article |
| id | doaj.art-a34cb95698054cd1aa87a175fc9f605d |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-12-18T06:56:12Z |
| publishDate | 2018-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-a34cb95698054cd1aa87a175fc9f605d2022-12-21T21:17:11ZengBMCBMC Cancer1471-24072018-01-011811810.1186/s12885-017-3952-7Differential efficacy of cisplatin plus pemetrexed between L858R and Del-19 in advanced EGFR-mutant non-squamous non-small cell lung cancerToshihiko Kaneda0Hiroshige Yoshioka1Motohiro Tamiya2Akihiro Tamiya3Akito Hata4Asukaka Okada5Takashi Niwa6Takayuki Shiroyama7Masaki Kanazu8Tadashi Ishida9Nobuyuki Katakami10Department of Respiratory Medicine, Kurashiki Central HospitalDepartment of Respiratory Medicine, Kurashiki Central HospitalDepartment of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic DiseasesDepartment of Internal Medicine, National Hospital Organization Kinki-chuo Chest Medical CenterDivision of Integrated Oncology, Institute of Biomedical Research and InnovationDepartment of Respiratory Medicine, Saiseikai Suita HospitalDepartment of Respiratory Medicine, Kurashiki Central HospitalDepartment of Thoracic Malignancy, Osaka Prefectural Medical Center for Respiratory and Allergic DiseasesDepartment of Internal Medicine, National Hospital Organization Kinki-chuo Chest Medical CenterDepartment of Respiratory Medicine, Kurashiki Central HospitalDivision of Integrated Oncology, Institute of Biomedical Research and InnovationAbstract Background LUX-Lung 3 showed afatinib improved progression-free survival (PFS) compared with cisplatin plus pemetrexed in patients with epidermal growth factor receptor (EGFR) mutations. In this study, chemotherapy efficacy tended to differ between patients with Leu858Arg (L858R) point mutation and Exon 19 deletion (Del-19); PFS in L858R patients (8.1 months) was greater than in Del-19 patients (5.6 months). We investigated whether there is any difference in efficacy of cisplatin plus pemetrexed between Del-19 and L858R. Methods This study is a multicenter retrospective study. We reviewed medical records of patients who had received cisplatin plus pemetrexed as first line chemotherapy. Efficacies were evaluated between EGFR mutation status: Del-19 and L858R. Wild type cases were reference arm only, and not included in any statistical analysis. Results Among 304 patients, 78 (25.7%) harbored EGFR mutations: Del-19 (36/78 patients, 46.2%); and L858R (42/78, 53.8%). Median PFS of L858R group (9.4 months, 95% confidence interval [CI]: 7.0–12.6) was significantly longer than Del-19 group (5.5 months, 95% CI, 3.6–8.6) (p = 0.049). Response rate (RR) and OS presented no significant difference between L858R and Del-19. In multivariate analysis, EGFR mutation status (L858R versus Del-19) was the only significant factor for longer PFS (Hazard ratio [HR]: 0.78, 95% CI: 0.62–0.98) (p = 0.033). Conclusion Our study indicated better efficacy of cisplatin plus pemetrexed in L858R than in Del-19 patients. In EGFR-mutant NSCLC, EGFR-TKIs are undoubtedly the premier therapy. However, in second line or later settings, cisplatin plus pemetrexed regimen may confer higher efficacy for L858R patients.http://link.springer.com/article/10.1186/s12885-017-3952-7Exon 19 deletionL858R point mutation in exon 21Non-squamous non-small cell lung cancerPemetrexedProgression-free survival |
| spellingShingle | Toshihiko Kaneda Hiroshige Yoshioka Motohiro Tamiya Akihiro Tamiya Akito Hata Asukaka Okada Takashi Niwa Takayuki Shiroyama Masaki Kanazu Tadashi Ishida Nobuyuki Katakami Differential efficacy of cisplatin plus pemetrexed between L858R and Del-19 in advanced EGFR-mutant non-squamous non-small cell lung cancer BMC Cancer Exon 19 deletion L858R point mutation in exon 21 Non-squamous non-small cell lung cancer Pemetrexed Progression-free survival |
| title | Differential efficacy of cisplatin plus pemetrexed between L858R and Del-19 in advanced EGFR-mutant non-squamous non-small cell lung cancer |
| title_full | Differential efficacy of cisplatin plus pemetrexed between L858R and Del-19 in advanced EGFR-mutant non-squamous non-small cell lung cancer |
| title_fullStr | Differential efficacy of cisplatin plus pemetrexed between L858R and Del-19 in advanced EGFR-mutant non-squamous non-small cell lung cancer |
| title_full_unstemmed | Differential efficacy of cisplatin plus pemetrexed between L858R and Del-19 in advanced EGFR-mutant non-squamous non-small cell lung cancer |
| title_short | Differential efficacy of cisplatin plus pemetrexed between L858R and Del-19 in advanced EGFR-mutant non-squamous non-small cell lung cancer |
| title_sort | differential efficacy of cisplatin plus pemetrexed between l858r and del 19 in advanced egfr mutant non squamous non small cell lung cancer |
| topic | Exon 19 deletion L858R point mutation in exon 21 Non-squamous non-small cell lung cancer Pemetrexed Progression-free survival |
| url | http://link.springer.com/article/10.1186/s12885-017-3952-7 |
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