TY - JOUR
T1 - The differential efficacy of pemetrexed according to NSCLC histology
T2 - A review of two phase III studies
AU - Scagliotti, Giorgio
AU - Hanna, Nasser
AU - Fossella, Frank
AU - Sugarman, Katherine
AU - Blatter, Johannes
AU - Peterson, Patrick
AU - Simms, Lorinda
AU - Shepherd, Frances A.
PY - 2009/3
Y1 - 2009/3
N2 - Background. Recent studies of pemetrexed have identified a predictive role for non-small cell lung cancer (NSCLC) histology. We further reviewed the differential efficacy of pemetrexed according to histology in two large, phase III NSCLC trials. Methods. One study tested pemetrexed versus do-cetaxel in previously treated patients (n = 571) and the other tested cisplatin plus pemetrexed versus cisplatin plus gemcitabine in chemotherapy-naive patients (n = 1,725) with advanced NSCLC. Cox proportional hazard models were used to test for covariate-adjusted treatment-by-histology interactions (THIs) for overall survival (os) and progression-free survival (PFs). For each histologic subgroup, the Kaplan-Meier method was used to estimate unadjusted within-arm medians, and Cox models were used to estimate covariate-ad- justed between-arm hazard ratios (HRs). Results. In both studies, treatment arms were well balanced for histology. THis were statistically significant (p < .005) for both OS and PFS. Nonsquamous patients treated with pemetrexed-based therapy experienced longer survival than the comparators (HR, 0.78 and 0.84, respectively), whereas squamous patients had shorter survival (HR, 1.56 and 1.23, respectively). Whereas the efficacy of pemetrexed regimens differed according to histology, it did not differ for docetaxel or for cisplatin plus gemcitabine. Pemetrexed was well tolerated across histologic groups.
AB - Background. Recent studies of pemetrexed have identified a predictive role for non-small cell lung cancer (NSCLC) histology. We further reviewed the differential efficacy of pemetrexed according to histology in two large, phase III NSCLC trials. Methods. One study tested pemetrexed versus do-cetaxel in previously treated patients (n = 571) and the other tested cisplatin plus pemetrexed versus cisplatin plus gemcitabine in chemotherapy-naive patients (n = 1,725) with advanced NSCLC. Cox proportional hazard models were used to test for covariate-adjusted treatment-by-histology interactions (THIs) for overall survival (os) and progression-free survival (PFs). For each histologic subgroup, the Kaplan-Meier method was used to estimate unadjusted within-arm medians, and Cox models were used to estimate covariate-ad- justed between-arm hazard ratios (HRs). Results. In both studies, treatment arms were well balanced for histology. THis were statistically significant (p < .005) for both OS and PFS. Nonsquamous patients treated with pemetrexed-based therapy experienced longer survival than the comparators (HR, 0.78 and 0.84, respectively), whereas squamous patients had shorter survival (HR, 1.56 and 1.23, respectively). Whereas the efficacy of pemetrexed regimens differed according to histology, it did not differ for docetaxel or for cisplatin plus gemcitabine. Pemetrexed was well tolerated across histologic groups.
KW - Adenocarcinoma
KW - Large cell carcinoma
KW - Non-small cell lung cancer
KW - Nonsquamous histology
KW - Pemetrexed
KW - Squamous cell carcinoma
KW - Thymidylate synthase
UR - http://www.scopus.com/inward/record.url?scp=64049115311&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=64049115311&partnerID=8YFLogxK
U2 - 10.1634/theoncologist.2008-0232
DO - 10.1634/theoncologist.2008-0232
M3 - Article
C2 - 19221167
AN - SCOPUS:64049115311
SN - 1083-7159
VL - 14
SP - 253
EP - 263
JO - Oncologist
JF - Oncologist
IS - 3
ER -