Pemetrexed-based chemotherapy in patients with advanced, ALK-positive non-small cell lung cancer Journal Article
| Authors: | Shaw, A. T.; Varghese, A. M.; Solomon, B. J.; Costa, D. B.; Novello, S.; Mino-Kenudson, M.; Awad, M. M.; Engelman, J. A.; Riely, G. J.; Monica, V.; Yeap, B. Y.; Scagliotti, G. V. |
| Article Title: | Pemetrexed-based chemotherapy in patients with advanced, ALK-positive non-small cell lung cancer |
| Abstract: | Background: Anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer (NSCLC) is highly responsive to crizotinib. To determine whether ALK-positive NSCLC is also sensitive to pemetrexed, we retrospectively evaluated progression-free survival (PFS) of ALK-positive versus ALK-negative patients who had been treated with pemetrexedbasedchemotherapy for advanced NSCLC.Patients and methods: We identified 121 patients with advanced, ALK-positive NSCLC in the USA, Australia, and Italy.Forcomparison, we evaluated 266 patients with advanced, ALK-negative, epidermal growth factor receptor(EGFR)-wild-type NSCLC, including 79 with KRAS mutations and 187 with wild-type KRAS (WT/WT/WT). We determined PFS on different pemetrexed regimens. Results: Among 70 ALK-positive patients treated with a platinum/pemetrexed regimen,the median PFS (mPFS) was 7.3 months (95% confidence interval (CI) 5.5-9.5). The mPFS of 51 ALK-positive patients treated with single-agent pemetrexed or nonplatinum/pemetrexed combinations was 5.5 months (2.8-9.0).For ALK-negative patients, PFS on all pemetrexed-based regimens was similar to that of ALK-positive patients, except in the specific setting of first-line platinum/pemetrexed where the mPFS was only 4.2 and 5.4 months in KRAS and WT/WT/WT patients, respectively. However, among patients with a never/light-smoking history (0-10 pack-year smoking history) treated with first-line platinum/pemetrexed, there was no difference in PFS between ALK-positive and ALK-negative patients. Conclusions: PFS on pemetrexed or nonplatinum/pemetrexed combinations was similar in ALK-positive and ALKnegative patients. PFS on first-line platinum/pemetrexed may be prolonged in never/light-smoking patients regardless of ALK status. © The Author 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. |
| Keywords: | adult; cancer survival; controlled study; aged; gene mutation; major clinical study; bevacizumab; cisplatin; advanced cancer; cancer combination chemotherapy; monotherapy; drug targeting; carboplatin; progression free survival; multiple cycle treatment; protein targeting; lung non small cell cancer; epidermal growth factor receptor; lung cancer; smoking; retrospective study; prediction; drug response; platinum derivative; oncogene k ras; thymidylate synthase; trend study; drug sensitivity; pemetrexed; alk; anaplastic lymphoma kinase; drug choice; maintenance chemotherapy |
| Journal Title: | Annals of Oncology |
| Volume: | 24 |
| Issue: | 1 |
| ISSN: | 0923-7534 |
| Publisher: | Oxford University Press |
| Date Published: | 2013-01-01 |
| Start Page: | 59 |
| End Page: | 66 |
| Language: | English |
| DOI: | 10.1093/annonc/mds242 |
| PROVIDER: | scopus |
| PMCID: | PMC3525134 |
| PUBMED: | 22887466 |
| DOI/URL: | |
| Notes: | --- - Cited By (since 1996):6 - "Export Date: 21 May 2013" - "Art. No.: mds242" - "CODEN: ANONE" - "Source: Scopus" |
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