Combination of chemotherapy and gefitinib as first-line treatment for patients with advanced lung adenocarcinoma and sensitive EGFR mutations: A randomized controlled trial.
Bao-Hui HanBo JinTianqing ChuYanjie NiuYu DongJianlin XuAiqing GuHua ZhongHuimin WangXueyan ZhangChunlei ShiYanwei ZhangWei ZhangYuqing LouLei ZhuJun PeiPublished in: International journal of cancer (2017)
To explore the optimal treatment strategy for patients who harbor sensitive EGFR mutations, a head-to-head study was performed to compare chemotherapy and gefitinib in combination or with either agent alone as first-line therapy, in terms of efficacy and safety. A total of 121 untreated patients with advanced lung adenocarcinoma who harbored sensitive EGFR mutations were randomly assigned to receive gefitinib combined with pemetrexed and carboplatin, pemetrexed plus carboplatin or gefitinib alone. The progression-free survival (PFS) of patients in the combination group (17.5 months, 95% CI, 15.3-19.7) was longer than that of patients in the chemotherapy group (5.7 months, 95% CI, 5.2-6.3) or gefitinib (11.9 months, 95% CI, 9.1-14.6) group. The (hazard ratios) HRs of PFS for the combination group vs. chemotherapy and gefitinib groups were 0.16 (95% CI, 0.09-0.29, p < 0.001) and 0.48 (95% CI, 0.29-0.78, p = 0.003), respectively. The overall response rate (ORR) in the combination therapy group, chemotherapy group and the gefitinib group was 82.5%, 32.5% and 65.9%, respectively. The combinational strategy resulted in longer overall survival (OS) than chemotherapy (HR = 0.46, p = 0.016) or gefitinib (HR = 0.36, p = 0.001) alone. Our finding suggested that treatment with pemetrexed plus carboplatin combined with gefitinib could provide better survival benefits for patients with lung adenocarcinoma harboring sensitive EGFR mutations.
Keyphrases
- small cell lung cancer
- epidermal growth factor receptor
- advanced non small cell lung cancer
- combination therapy
- locally advanced
- end stage renal disease
- free survival
- tyrosine kinase
- newly diagnosed
- chronic kidney disease
- phase ii study
- peritoneal dialysis
- prognostic factors
- radiation therapy
- randomized controlled trial
- clinical trial
- patient reported outcomes
- phase iii
- mesenchymal stem cells
- chemotherapy induced
- patient reported
- open label