Volume 29, Issue 4, 2020
DOI: 10.24205/03276716.2020.886
Efficacy and Safety of Pemetrexed Combined with Carboplatin in The Treatment Of EGFR-Mutant Advanced NSCLC Patients After First-Line EGFR-TKI Failure
Abstract
Objective: To investigate the efficacy and safety of pemetrexed combined with carboplatin in the treatment of epidermal growth factor receptor (EGFR)-mutant advanced non-small cell lung cancer (NSCLC) patients after failure of first-line targeted EGFR-tyrosine kinase inhibitor (TKI).
Method: 84 NSCLC patients admitted to xx hospital from March 2017 to March 2019 were involved and divided into the control group (n = 42) and the observation group (n = 42) according to the treatment received. The control group and the observation group were treated with docetaxel combined with carboplatin and pemetrexed combined with carboplatin, respectively. Two to six treatment cycles were applied, until the patient refused to receive further treatment or the disease progressed. After 2 cycles, the two groups were compared in terms of disease remission rates (ORR) and disease control rates (DCR). ELISA was employed to detect serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), cytokeratin 19 fragment (CYFRA21-1), and vascular endothelial growth factor (VEGF). The incidences of adverse reactions and survival of patients during the follow-up period were recorded.
Results: ORR and DCR of the observation group were 45.23% and 76.19% (P<0.05), respectively, which were higher than those of the control group by 23.81% and 52.38%, respectively. Before treatment, there was no significant difference in serum levels of CEA, CA125, CYFRA21-1 and VEGF between these two group (P>0.05). After two treatment cycles, the serum levels of CEA, CA125, CYFRA21-1 and VEGF of patients in both groups were lower than those before treatment, while the serum levels of CEA, CA125, CYFRA21-1 and VEGF of patients in the observation group were lower than those of patients in the control group (P<0.05). The incidence rate of adverse reactions in the observation group was lower than that in the control group (P<0.05). As of March 2020, 60 of the 84 NSCLC patients died. The mortality of the observation group was 61.90% (26/42), which was lower than that of the control group (80.95%, 34/42). The median survival time of the observation group was 27 months, which was higher than that of the control group by 16 months (P<0.05).
Conclusions: The combination of pemetrexed and carboplatin in the treatment of NSCLC exhibits an excellent effect as it can significantly reduce the serum levels of tumor markers and adverse reactions. Characterized by high safety and effectively prolonged patient survival, this treatment is worthy of promotion and application.
Keywords
non-small cell lung cancer (NSCLC); pemetrexed; carboplatin; epidermal growth factor receptor