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Title: First-Line Pemetrexed Plus Cisplatin Followed by Gefitinib Maintenance Therapy Versus Gefitinib Monotherapy in East Asian Never-Smoker Patients with Locally Advanced or Metastatic Nonsquamous Non-Small-cell Lung Cancer: Quality of Life Results from a Randomized Phase III Trial
Authors: Mark Boye
Xin Wang
Vichien Srimuninnimit
Jin Hyoung Kang
Chun Ming Tsai
Mauro Orlando
Tarun Puri
Jong Seok Kim
Narayan Rajan
James Chih Hsin Yang
Eli Lilly and Company
Mahidol University
The Catholic University of Korea
National Yang-Ming University Taiwan
Eli Lilly Interamerica Inc.
Eli Lilly Australia Pty Ltd.
National Taiwan University Hospital
Keywords: Biochemistry, Genetics and Molecular Biology
Issue Date: 1-Mar-2016
Citation: Clinical Lung Cancer. Vol.17, No.2 (2016), 150-160
Abstract: © 2016 Eli Lilly and Company. Background The efficacy results from an open-label, randomized, multicenter study found no significant difference in progression-free survival between pemetrexed plus cisplatin followed by maintenance gefitinib (PC/G) and gefitinib monotherapy (G) in patients with advanced nonsquamous non-small-cell lung cancer (NSCLC) and unknown epidermal growth factor receptor (EGFR) mutation status (hazard ratio favored PC/G). The present report describes the quality of life (QoL) results from that trial. Patients and Methods Chemotherapy-naive, East Asian, light ex-smokers or never-smokers with advanced nonsquamous NSCLC and unknown EGFR mutation status (n = 236) were randomly assigned (1:1) to PC/G or G. EGFR mutation status was subsequently determined for 74 patients. The symptoms and QoL were assessed using the Lung Cancer Symptom Scale (LCSS). The time to worsening of symptoms (TWS) was analyzed using the Kaplan-Meier method. Results In the overall population, the TWS was generally longer in the G group (n = 109) than in the PC/G group (n = 109) for the LCSS symptoms classified as treatment-related (loss of appetite, fatigue) and tumor-related (cough, dyspnea, hemoptysis, pain). In the subgroup of patients with wild-type EGFR, the TWS was generally longer in the PC/G group (n = 13) than in the G group (n = 8) for the tumor-related LCSS symptoms. Conclusion In this study population clinically selected to respond to gefitinib, the LCSS scores were more favorable in the G group than in the PC/G group. Patients with wild-type EGFR tended to show greater improvement in tumor-related LCSS symptoms with chemotherapy than with gefitinib alone. These LCSS outcomes provide further evidence that patients with wild-type EGFR might not benefit from first-line treatment of advanced NSCLC with gefitinib.
ISSN: 19380690
Appears in Collections:Scopus 2016-2017

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