Abstract CT323: Pemetrexed versus docetaxel in patients with EGFR-mutant lung adenocarcinoma previously treated with epidermal growth factor receptor tyrosine kinase inhibitors

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Abstract Background: Patients with epidermal growth factor receptor (EGFR) mutation positive adenocarcinoma exhibited marked response to EGFR tyrosine kinase inhibitors (TKIs). In most cases, the patients showed disease progression after EGFR TKI treatment. We evaluated the efficacy and safety of pemetrexed versus docetaxel after the failure of EGFR TKI in patients with adenocarcinoma with EGFR mutation. Methods: Patients harboring EGFR mutant adenocarcinoma who received weekly docetaxel (35-40 mg/m2 on days 1 and 8 every 3 weeks) or pemetrexed (500 mg/m2 every 3 weeks) at a single university-affiliated hospital following failure of first line EGFR TKI treatment were retrospectively reviewed. Results: 44 patients were included between 2012 and 2013. Patients who had previously treated with EGFR TKI as first line treatment were received docetaxel (n=11) or pemetrexed (n=33) in second- or later-line treatment. The efficacy of docetaxel was superior to that of pemetrexed (ORR: 36.4% vs. 6.1%, p = 0.011, DCR: 72.7% vs. 39.4%, p = 0.055). Progression-free survival of docetaxel was 6.2 months versus 1.9 months with pemetrexed. (HR 0.55; 95% CI 0.25-1.22; p = 0.140). There were no significant differences in either the grade 3-4 hematologic or nonhematologic toxicities between the 2 regimens. Conclusion: Pemetrexed shows unfavorable result compared to docetaxel in patients with acquired drug resistance after EGFR TKI treatment. We will have to study the efficacy of pemetrexed versus docetaxel after EGFR TKI treatment prospectively. Citation Format: Kim Kyu-Sik, Bo Ram Lee, Sung Hoon Yoon, Jinyeong Yu, Injae Oh, Young Chul Kim, Sangyun Song, yooduk Choi, Hee Jung Ban. Pemetrexed versus docetaxel in patients with EGFR-mutant lung adenocarcinoma previously treated with epidermal growth factor receptor tyrosine kinase inhibitors. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr CT323. doi:10.1158/1538-7445.AM2014-CT323