Clinical Characteristics And Outcome For Patients With Advanced Lung Adenocarcinoma Treated With First-line Pemetrexed Plus Platinum

Clinical characteristics and outcome for patients with advanced lung adenocarcinoma treated with first-line pemetrexed plus platinumObjective:This Study aims to explore the efficacy and safety of pemetrexed maintenance therapy in patients with advanced lung adenocarcinomaafter first-line treatment with pemetrexed and platinum for Chinese populations in the real world.Methods:This was a single-center,retrospective study.We retrospectively evaluated the data from patients with advanced lung adenocarcinoma treated with first-line pemetrexed plus platinum from February 2011 to August 2017.Patients were divided into 2 groups according to the presence of maintenance therapy(yes or no)after the first-line chemotherapy.The primary endpoint was progression-free survival(PFS),secondary endpoints included objective response rate(ORR),disease control rates(DCR),and safety.Univariate and multivariate analysis in Cox proportional hazards regression model were used to explore the prognostic factors.Results:There were 450 patients with lung adenocarcinoma,A total of 292 received only first-line pemetrexed-based therapy,while 158 patients received maintenance pemetrexed after induction.The overall median PFS was 5.83 months(95%CI was 0.33 to 55.72 months).The ORR and DCR was 33.6%and 87.6%,respectively.The maintenance treatment group had longer PFS(9.92 months,95%CI:8.70 to 11.14 months)than the non-maintenance treatment group(4.60 months,95%CI:3.98 to 5.21 months)after the first line chemotherapy(P<0.001).Single-factor and multiple-factor analysis showed that positive mutation of epidermal growth factor receptor(EGFR),PS 0,exposure more than 4 cycle,and the addition of maintenance treatment were the positive prognostic factors for survival.The main adverse reactions of the patients were hematological toxicity,gastrointestinal reaction,abnormal and asthenia of liver function.However,low incidence of grade 3 or higher toxicity was seen in this study.Conclusion:First-line therapy with pemetrexed combined with platinum is safe and effective for advanced lung adenocarcinoma,and pemetrexed maintenance therapy has a better survival benefit.