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A Review of Regimens Combining Pemetrexed With an Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor in the Treatment of Advanced Nonsquamous Non-Small-Cell Lung Cancer
- Source :
- Clinical lung cancer. 19(1)
- Publication Year :
- 2017
-
Abstract
- Pemetrexed is a standard first-line treatment for advanced nonsquamous non-small-cell lung cancer (NSCLC), and epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are a standard first-line treatment for advanced nonsquamous NSCLC with activating EGFR mutations. Pemetrexed and EGFR TKIs have different mechanisms of action and minimally overlapping toxicity profiles; therefore, it is hypothesized that their combination might result in acceptable toxicity, provided that the synergistic antitumor activity observed in preclinical studies is achieved. This review summarizes clinical trials of pemetrexed in combination with an EGFR TKI for the treatment of advanced nonsquamous NSCLC in the first- and second-line settings, using intercalated, sequential, and concurrent treatment strategies. As would be expected, such strategies were most efficacious in patients with the activating EGFR mutations associated with response to an EGFR TKI. In the studies that compared a pemetrexed-EGFR TKI combination with pemetrexed alone or the EGFR TKI alone, the pemetrexed-EGFR TKI combination was more efficacious than the single-agent regimens. The pemetrexed-EGFR TKI combinations were generally associated with a higher incidence of grade 3/4 treatment-related adverse events than the single-agent regimens; however, such toxicities were clinically manageable. Future studies of pemetrexed-EGFR TKI combinations should focus on optimizing treatment strategies in patients with activating EGFR mutations.
- Subjects :
- 0301 basic medicine
Pulmonary and Respiratory Medicine
Oncology
Cancer Research
medicine.medical_specialty
Lung Neoplasms
medicine.medical_treatment
Pemetrexed
Targeted therapy
03 medical and health sciences
0302 clinical medicine
Gefitinib
Internal medicine
Carcinoma, Non-Small-Cell Lung
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Epidermal growth factor receptor
Lung cancer
Protein Kinase Inhibitors
Neoplasm Staging
Chemotherapy
Clinical Trials as Topic
biology
business.industry
medicine.disease
respiratory tract diseases
ErbB Receptors
030104 developmental biology
030220 oncology & carcinogenesis
Mutation
biology.protein
Erlotinib
business
Tyrosine kinase
medicine.drug
Subjects
Details
- ISSN :
- 19380690
- Volume :
- 19
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Clinical lung cancer
- Accession number :
- edsair.doi.dedup.....afd6470bdabefa849235a313c249826d