Efficacy and toxicity of pemetrexed versus docetaxel in patients with advanced non-small cell lung cancer previously treated with EGFR-TKIs

QU Binbin; CHEN Xia; WANG Lisheng; HUANG Xiao; LI Xvtong

Abstract：Objective To explore the efficacy and toxicity of pemetrexed versus docetaxel in patients with advanced non-small cell lung cancer(NSCLC) previously treated with epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs). Methods In this retrospective study, 67 cases of NSCLC patients failed to EGFR-TKIs were enrolled. According to the treatment regimen, the pa-tients were assigned to receive docetaxel(75 mg/ m2 d1 , n= 31) or pemetrexed(500 mg/ m2 d1 , n= 36) with 21 days for a cycle. The efficacy was evaluated according to response evaluation criteria in solid tumors(RECIST 1. 1). The toxicity was evaluated by interna-tional standard adverse reaction NCI CTC 3. 0 version. The long-term survival was followed up and the Cox hazard regression model to analyze the influencing factors for the prognosis. Results All patients can be evaluated for the short-term efficacy. The response rates of pemetrexed group and docetaxel group were 19. 4% and 12. 9%, and disease control rates were 58. 3% and 41. 9% without signifi-cant difference(P>0. 05). In pemetrexed group, the incidence of grade 3-4 white blood cell reduction, thrombocytopenia, skin rash and elevated aminotransferase were all lower than that of docetaxel group(P<0. 05). The median progression free survival(PFS) was 6. 4 months in the pemetrexed group, higher than 4. 7 months in docetaxel group with significant differences(P<0. 05). No significant difference was observed in the median overall survival between both groups(P>0. 05). Factors affecting the PFS included age, clinical stage, pathological type, PS score and save program. Conclusion Similar efficacy was observed between pemetrexed and docetaxel in NSCLC patients failed to EGFR-TKIs. However, the median PFS was relatively high, and the side effects were slight and could be tol-erated in pemetrexed regiem. In view of the factors influencing the prognosis, it could be recommended to use in the treatment of the patients.