Phase II study of pemetrexed and erlotinib in pretreated nonsquamous, non-small-cell lung cancer patients without an EGFR mutation

Chemotherapy. 2013;59(6):414-9. doi: 10.1159/000363731. Epub 2014 Jul 16.

Abstract

Background: Preclinical data indicated that the combination of erlotinib and pemetrexed is synergistic when erlotinib is administered after pemetrexed.

Patients and methods: This was a phase II study of pemetrexed and erlotinib in patients with pretreated advanced non-squamous non-small-cell lung cancer (NSCLC) with wild-type epidermal growth factor receptor (EGFR). Chemotherapy consisted of pemetrexed (500 mg/m(2)) on day 1 and erlotinib (150 mg/body) on days 2-15 every 3 weeks. The protocol treatment was repeated until disease progression or intolerable toxicities occurred.

Results: Seventeen patients were enrolled between January 2010 and January 2013, and 15 patients were evaluable for both safety and efficacy. The study was terminated due to slow patient accrual. There was 1 complete response. There was a partial response in 3 patients, stable disease in 4 and progressive disease in 7. The response rate was 27% and disease control rate was 53%. The median progression-free survival and overall survival were 2.5 months and 6.7 months, respectively.

Conclusions: Statistical interpretation could not been made due to the early termination of the study. Further studies are needed to clarify the efficacy of this regimen in NSCLC patients without EGFR mutation (UMIN-CTR No. 0000024531).

Publication types

  • Clinical Trial, Phase II

MeSH terms

  • Aged
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Disease-Free Survival
  • Drug Administration Schedule
  • Drug Therapy, Combination
  • ErbB Receptors / genetics
  • ErbB Receptors / metabolism
  • Erlotinib Hydrochloride
  • Female
  • Glutamates / adverse effects
  • Glutamates / therapeutic use*
  • Guanine / adverse effects
  • Guanine / analogs & derivatives*
  • Guanine / therapeutic use
  • Humans
  • Lung Neoplasms / drug therapy*
  • Male
  • Middle Aged
  • Mutation
  • Neutropenia / etiology
  • Pemetrexed
  • Quinazolines / adverse effects
  • Quinazolines / therapeutic use*
  • Thrombocytopenia / etiology
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Glutamates
  • Quinazolines
  • Pemetrexed
  • Guanine
  • Erlotinib Hydrochloride
  • EGFR protein, human
  • ErbB Receptors