Clinical efficacy analysis of pemetrexed combined with gefitinib in treatment of advanced non-small cell lung cancer after epidermal growth factor receptor-tyrosine kinase inhibitor drug resistance

Abstract

Objective To investigate the clinical efficacy of pemetrexed alone or combined with gefitinib in treatment of advanced non-small cell lung cancer (NSCLC) after epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) drug resistance. Methods The clinical data of 80 patients with advanced NSCLC after EGFR-TKI drug resistance from August 2014 to April 2018 were retrospectively analyzed. They were divided into two groups according to their treatment regimens: 40 patients received pemetrexed alone (the control group) and 40 patients received pemetrexed combined with gefitinib (the observation group). The recent clinical efficacy, adverse reactions and the survival time of both groups were compared. The count data was compared by using χ 2 test or Fisher exact test. Kaplan-Meier method was used to make survival analysis and log-rank method was used to detect. Results The total effective rate of the observation group was higher than that of the control group [70.0% (28/40) vs. 32.5% (13/40), χ2 = 11.257, P = 0.001]. There was no statistical difference in the adverse reactions [17.5% (7/40) vs. 20.0% (8/40), χ2 = 0.082, P = 0.775]. The median progression-free survival time and median overall survival time of the observation group were longer than those of the control group (6.5 months vs. 3.5 months, 15.5 months vs. 8.5 months, all P < 0.01). Conclusion Pemetrexed combined with gefitinib has a recent favorable effect in advanced NSCLC after EGFR-TKI drug resistance, including low incidence of adverse reactions and prolonged survival time, which is worthy of further application. Key words: Carcinoma, non-small-cell lung; Drug resistance, neoplasm; Receptor, epidermal growth factor; Protein-tyrosine kinases; Enzyme inhibitors; Gefitinib; Pemetrexed