Journal of Shandong University (Health Sciences) ›› 2018, Vol. 56 ›› Issue (9): 29-34.doi: 10.6040/j.issn.1671-7554.0.2018.419

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Clinical analysis of gefitinib versus pemetrexed combined with cisplatin in patients with stage Ⅱ-ⅢA lung adenocarcinoma harbouring positive EGFR mutations

XIE Hounai, LI Meng, XU Lin, WANG Hui, PENG Yue, PENG Zhongmin   

  1. Department of Thoracic Surgery, Shandong Provincial Hospital Affliated to Shandong University, Jinan 250021, Shandong, China
  • Published:2022-09-27

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Abstract: Objective To compare the efficacy of geftinib versus pemetrexed/cisplatin in patients with EGFR-mutant stage Ⅱ-ⅢA lung adenocarcinoma, and to provide a reference for the therapy of postoperative lung adenocarcinoma. Methods A total of 103 patients with pathological stage Ⅱ-ⅢA lung adenocarcinoma combined with positive epidermal growth factor receptor(EGFR)mutations were enrolled between January 2013 and April 2017, and divided into pemetrexed + cisplatin(PC)group and gefitinib(GE)group. All events continued untill disease relapse, death, or unacceptable toxic effects. Factors affecting survival were assessed by Kaplan-Meier method and Cox regression analysis. 山 东 大 学 学 报 (医 学 版)56卷9期 -谢厚耐,等.吉非替尼对比培美曲塞联合顺铂治疗术后EGFR突变阳性Ⅱ~ⅢA期肺腺癌的临床分析 \=- Results The median follow-up time was 32.3 months in PC group and 37.0 months in GE group. Median disease-free survival(DFS)was significantly longer in GE group than that in PC group(34.9 vs 21.0 months, P=0.002). Overall survival(OS)was not significantly different between the two groups(P=0.182). The most common adverse events in PC group were neutropenia(58.8%)followed by nausea or vomiting(56.9%)and anemia(45.1%), and in GE group were rash(76.9%), aminotransferase elevation(48.1%)and diarrhoea(42.3%). The incidence of hematological toxicity, gastrointestinal toxicity and alopecia in PC group was significantly higher than that in GE group(P=0.001; P<0.001; P=0.020). Interstitial lung disease(ILD), which was regarded as the most severe treatment-related adverse event, was diagnosed in one patient after receiving gefitinib three months. The incidence of sever adverse events(grade≥3)was significantly lower in GE group than that in PC group(13.5% vs 33.3%, P=0.020). Conclusion Compared with chemotherapy with pemetrexed/cisplain, gefitinib shows a significant DFS benefit in patients with EGFR mutation-positive and completely resected stage Ⅱ-ⅢA lung adenocarcinoma and is associated with more favourable tolerability. Adjuvant geftinib could be a potential treatment option compared with adjuvant chemotherapy in these patients.

Key words: Lung adenocarcinoma, Epidermal growth factor receptor mutation, Gefitinib, Pemetrexed, Adjuvant chemotherapy

CLC Number: 

  • R655.3
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