Title |
Chemotherapy with or without pemetrexed as second-line regimens for advanced non-small-cell lung cancer patients who have progressed after first-line EGFR TKIs: a systematic review and meta-analysis
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Published in |
OncoTargets and therapy, June 2018
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DOI | 10.2147/ott.s160147 |
Pubmed ID | |
Authors |
Zhihua Li, Haiyan Guo, Yiyu Lu, Jianxin Hu, Haitao Luo, Weiguang Gu |
Abstract |
The development of acquired resistance to the first-line epidermal growth factor-tyrosine kinase inhibitor (EGFR-TKI) treatment in non-small-cell lung cancer (NSCLC) is inevitable, and most of these patients needed second-line chemotherapy. Furthermore, the optimum chemotherapeutic regimen is unclear. The aim of this meta-analysis was to evaluate the chemotherapeutic regimens "with-pemetrexed" versus "non-pemetrexed" in advanced NSCLC patients who had progressed after first-line EGFR-TKIs. We searched PubMed, Embase, Cochrane Library, and the Web of science for relevant clinical trials. Outcomes analyzed were response rate (RR), disease control rate (DCR), 1-year survival rate (1-year SR), progression-free survival (PFS), and overall survival (OS). One randomized controlled trial (RCT) and three retrospective studies were included in this meta-analysis, covering a total of 354 patients. The results showed that there was no significant difference between with-pemetrexed arm and non-pemetrexed arm in RR (OR 1.43, 95% CI 0.85-2.41, P=0.18), DCR (OR 1.5, 95% CI 0.94-2.39, P=0.09), and 1-year SR (OR 1.47, 95% CI 0.79-2.74, P=0.22). But the with-pemetrexed chemotherapeutic regimens significantly improved the PFS (HR 0.61, 95% CI 0.46-0.81, P=0.0005) and OS (HR 0.62, 95% CI 0.42-0.90, P=0.01). The second-line with-pemetrexed chemotherapeutic regimens provided significantly longer PFS and OS than non-pemetrexed chemotherapeutic regimens. These findings indicate that the with-pemetrexed chemotherapeutic regimen may be an optimal second-line chemotherapeutic regimen for patients with advanced NSCLC following EGFR-TKI failure. |
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Country | Count | As % |
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Demographic breakdown
Readers by professional status | Count | As % |
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Researcher | 3 | 17% |
Student > Postgraduate | 2 | 11% |
Student > Master | 2 | 11% |
Lecturer | 1 | 6% |
Student > Bachelor | 1 | 6% |
Other | 3 | 17% |
Unknown | 6 | 33% |
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Pharmacology, Toxicology and Pharmaceutical Science | 2 | 11% |
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Business, Management and Accounting | 1 | 6% |
Unknown | 6 | 33% |