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Survival Benefit and Genetic Profile of Pemetrexed as Initial Chemotherapy in Selected Chinese Patients With Advanced Lung Adenocarcinoma(Open Access)

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机构： [1]Department of Medical Oncology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-Sen University, Meizhou, China [2]Guangdong Lung Cancer Institute, Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China [3]Department of Oncology, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, China [4]Department of Respiratory Disease, Thoracic Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China [5]Sichuan Cancer Hospital Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China [6]Internal Medicine (Respiratory) of Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Shangdong Academy of Medical Sciences, Shangdong Cancer Hospital and Institute, Jinan, China [7]Lung Cancer and Gastrointestinal Unit, Department of Medical Oncology, Hunan Cancer Hospital/Affiliated Cancer Hospital of Xiangya School of Medicine, Changsha, China [8]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Oncology, Peking University Cancer Hospital and Institute, Beijing, China [9]Respiratory Medicine Department, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute for Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China [10]Department of Cadre Medical Oncology, No.3 Hospital Affiliated to Kunming Medical College, Kunming, China [11]Department of Thoracic Medical Oncology, Zhejiang Cancer Hospital, Hangzhou, China [12]Department of Radiation and Medical Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China [13]Department of Medical Oncology, Chinese PLA General Hospital, Beijing, China [14]Department of Medical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China [15]Department of Oncology, Dongguan People's Hospital, Dongguan, China [16]Department of Thoracic Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, China [17]Cancer Center, The First Hospital of Jilin University, Changchun, China [18]Department of Thoracic Surgery, Peking University People's Hospital, Beijing, China [19]Department of Medical Oncology, Cancer Hospital of Shantou University Medical College, Shantou, China [20]Department of Medical Oncology, Jilin Provincial Cancer Hospital, Changchun, China [21]Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University/Henan Cancer Hospital, Zhengzhou, China [22]Department of Lung Cancer, Tianjin Medical University Cancer Institute Hospital, Tianjin, China [23]Department of Medical Oncology, The First Hospital of China Medical University, Shenyang, China [24]Department of Thoracic Surgery, General Hospital of Southern Theater Command, PLA, Guangzhou, China [25]Department of Thoracic Surgery, Shenzhen People's Hospital, 2nd Clinical Medical College of Jinan University, Shenzhen, China [26]Department of Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China [27]Department of Thoracic Surgery, Nanfang Hospital of Southern Medical University, Guangzhou, China [28]Oncology Department, The First College of Clinical Medical Science, Three Gorges University Yichang Central People's Hospital, Yichang, China [29]Department of Medical Oncology, Yantai Yuhuangding Hospital, Yantai, China [30]Chemotherapy Section One, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China [31]Department of Respiratory and Critical Care, Tianjin Chest Hospital, Tianjin, China [32]Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China [33]Oncology Department, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China [34]Department of Clinical Oncology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China [35]Department of Oncology, The First Affiliated Hospital of Dalian Medical University, Dalian, China [36]Department of Oncology, The Second Hospital, Harbin Medical University, Harbin, China [37]Department of Oncology, Henan Provincial People's Hospital, Zhengzhou, China [38]Department of Pulmonary Oncology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China [39]Department of Respiratory Medicine, Shanxi Provincial Cancer Hospital, Taiyuan, China [40]Department of Pulmonary Oncology, The Fifth Medical Centre, Chinese PLA General Hospital, Beijing, China [41]Institute of Cancer, Xinqiao Hospital, The Third Military Medical University, Chongqing, China [42]Thoracic Surgery, Hainan General Hospital, Haikou, China [43]Cancer Center, The Second Xiangya Hospital, Central South University, Changsha, China [44]Department of Oncology, The 900th Hospital of the People's Liberation Army Joint Service Support Force, Fuzong Clinical Medical College, Fujian Medical University, Fuzhou, China

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关键词： chemotherapy Chinese lung adenocarcinoma next-generation sequencing pemetrexed

摘要：

Objective: This study investigated survival in selected Chinese patients with advanced lung adenocarcinoma who received initial chemotherapy with pemetrexed. We also explored the relationship between genetic biomarkers and pemetrexed efficacy. Methods: We retrospectively collected patients (n = 1,047) enrolled in the Chinese Patient Assistance Program from multiple centers who received pemetrexed alone or combined with platinum as initial chemotherapy and continued pemetrexed maintenance therapy for advanced lung adenocarcinoma from November 2014 to June 2017. The outcomes were duration of treatment (DOT) and overall survival (OS). Clinical features were analyzed for their influence on the treatment effect and prognosis. Next-generation sequencing (NGS) was performed to identify genetic biomarkers associated with the efficacy of pemetrexed. Results: The median DOT was 9.1 months (95% CI: 8.5–9.8), and the median OS was 26.2 months (95% CI: 24.2–28.1). OS was positively correlated with DOT (r = 0.403, P < 0.001). Multivariable analysis showed that smoking status and Eastern Cooperative Oncology Group (ECOG) performance status (PS) were independently associated with DOT; smoking status, ECOG PS, targeted therapy, and EGFR/ALK/ROS1 status were independently associated with OS. NGS in 22 patients with available samples showed genes with high mutation rates were: TP53 (54.5%), EGFR (50.0%), MYC (18.2%), and PIK3CA (13.6%). When grouped based on progression-free survival (PFS) reported in the PARAMOUNT study, the DOT > 6.9 months set was associated with PIK3CA, ALK, BRINP3, CDKN2A, CSMD3, EPHA3, KRAS, and RB1 mutations, while ERBB2 mutation was observed only in the DOT ≤ 6.9 months set. Conclusion: This study shows that initial chemotherapy with pemetrexed is an effective regimen for advanced lung adenocarcinoma in selected Chinese patients. There is no specific genetic profile predicting the benefit of pemetrexed found by NGS. Biomarkers predicting the efficacy of pemetrexed need further exploration. © Copyright © 2020 Guo, Zhang, Zhang, Zhou, Cai, Long, Guo, Yang, Zhao, Xie, Jiang, Zhu, Fan, Xie, Hu, Yao, Jia, Li, Cui, Sui, Lin, Cheng, Wang, Wang, Zhao, Qiao, Peng, Yang, Chen, Cai, Xu, Zhang, Feng, Zhou, Wu, Dong, Wang, Zhang, Gao, Jiang, Cang, Yang, Song, Liu, Zhu, Chen, Hu, Chen, Wu and Zhou.

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出版当年[2020]版：

大类 | 3 区医学

小类 | 3 区肿瘤学

最新[2023]版：

大类 | 3 区医学

小类 | 3 区肿瘤学

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出版当年[2020]版：

Q2 ONCOLOGY

最新[2023]版：

Q2 ONCOLOGY

影响因子： 3.5 最新[2023版] 4 最新五年平均 6.244 出版当年[2020版] 6.264 出版当年五年平均 4.848 出版前一年[2019版] 5.738 出版后一年[2021版]

第一作者：

第一作者机构： [1]Department of Medical Oncology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-Sen University, Meizhou, China

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Survival Benefit and Genetic Profile of Pemetrexed as Initial Chemotherapy in Selected Chinese Patients With Advanced Lung Adenocarcinoma(Open Access)

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