Exceptional pemetrexed sensitivity can predict therapeutic benefit from subsequent chemotherapy in metastatic non-squamous non-small cell lung cancer
Exceptional pemetrexed sensitivity can predict therapeutic benefit from subsequent chemotherapy in metastatic non-squamous non-small cell lung cancer
复制标题
DOI：
10.1007/s00432-019-02941-z
复制
发表时间：
2019-07-01
影响因子：
3.6
通讯作者：
Lee, Jae Cheol
中科院分区：
文献类型：
--
作者：
Park, Ji Hyun;Kwon, Byoung Soo;Lee, Jae Cheol
目的基于在一些转移性 NSCLC 患者中观察到的对培美曲塞异常持久的反应，研究了培美曲塞敏感性对后续全身治疗结果的预测价值。方法我们回顾性审查了 2006 年 11 月至 2015 年 2 月期间接受培美曲塞单药治疗作为一线或二线化疗的转移性非鳞状 NSCLC 患者。好反应者（最长的前 5%）和差反应者（后 12%）最短）是根据培美曲塞维持的持续时间来定义的。首次和第二次培美曲塞（PP）后全身治疗分别定义为PP1和PP2疗法，将其无进展生存期（PFS）定义为PFS1和PFS2。结果在总共100名患者中，86%的患者接受培美曲塞作为二线化疗，34%被归类为良好反应者。良好和不良反应组的中位反应持续时间分别为 20.5 个月和 0.7 个月。培美曲塞治疗失败后，分别有 74% 和 41.9% 的患者接受了 PP1 和 PP2 治疗。令我们惊讶的是，在接受 PP1 治疗的患者中，良好反应组的疾病控制率 (DCR) 显着高于不良反应组（69.6% vs 37.3%，p=0.010），并且中位 PFS1 也显着更长（5.2vs2.2 个月，p
PurposeBased on an exceptionally durable response to pemetrexed observed in some patients with metastatic NSCLC, the predictive value of pemetrexed sensitivity to outcomes of subsequent systemic treatment was investigated.MethodsWe retrospectively reviewed the patients with metastatic non-squamous NSCLC treated with pemetrexed monotherapy as their first- or second-line chemotherapy between November 2006 and February 2015. Good (top 5% longest) and poor responders (bottom 12% shortest) were defined according to the duration of pemetrexed maintenance. The first and second post-pemetrexed (PP) systemic treatments were defined as PP1 and PP2 therapies, respectively, to define their progression-free survivals (PFS) as PFS1 and PFS2.ResultsIn a total of 100 patients, 86% of patients received pemetrexed as their second-line chemotherapy, and 34% were classified as good responders. Good and poor responder groups showed 20.5months and 0.7months of the median duration of responses, respectively. PP1 and PP2 therapies were done in 74% and 41.9% of patients after failure to pemetrexed. To our surprise, disease control rate (DCR) was significantly higher in the good responder group than poor responder group (69.6% vs 37.3%, p=0.010) in patients treated with PP1 therapy, and median PFS1 was also significantly longer (5.2vs2.2 months, p