title: Efficacy of chemotherapy in epidermal growth factor receptor (EGFR) mutated metastatic pulmonary adenocarcinoma patients who had acquired resistance to first-line EGFR tyrosine kinase inhibitor (TKI).
abstract: BACKGROUND
  Salvage chemotherapy is frequently used when tumour epidermal growth factor receptor (EGFR) mutated patients experience disease progression with first-line EGFR-tyrosine kinase inhibitor (TKI) treatment. However, the efficacy of salvage chemotherapy is still unknown.
  
  
  METHODS
  We retrospectively reviewed the chart records of our pulmonary adenocarcinoma patients between 2010 and 2013.
  
  
  RESULTS
  Five hundred and six of the 1240 stage IV adenocarcinoma patients had an EGFR mutation and 338 received first-line EGFR-TKI treatment. In all, 169 patients in this group received salvage chemotherapy after failure of EGFR-TKI, and 102 patients were eligible for this study. The chemotherapy response rate of these 102 patients was 24.5%, with a median progression-free survival (PFS) of 4.5?months, and median survival time was 14.6?months. Patients who received pemetrexed-based chemotherapy had longer PFS and overall survival (OS), although the extent was statistically insignificant. Progression-free survival and OS were longer for patients who received combination chemotherapy than single-agent chemotherapy.
  
  
  CONCLUSIONS
  Pemetrexed-based combination chemotherapy is preferred before a more efficient treatment strategy is found.
authors.affiliation: a Department of Chest Medicine , Taipei Veterans General Hospital , Taipei , Taiwan , Republic of China.|b School of Medicine , National Yang-Ming University , Taipei , Taiwan , Republic of China.
authors.forename: Yen-Han
authors.initials: YH
authors.lastname: Tseng
authors.affiliation: c Department of Nursing , Taipei Veterans General Hospital , Taipei , Taiwan , Republic of China.
authors.forename: Hsiu-Ying
authors.initials: HY
authors.lastname: Hung
authors.affiliation: c Department of Nursing , Taipei Veterans General Hospital , Taipei , Taiwan , Republic of China.
authors.forename: Yi-Chen
authors.initials: YC
authors.lastname: Sung
authors.affiliation: d Division of Thoracic Surgery, Department of Surgery , Taipei Veterans General Hospital , Taipei , Taiwan , Republic of China.
authors.forename: Yen-Chiang
authors.initials: YC
authors.lastname: Tseng
authors.affiliation: a Department of Chest Medicine , Taipei Veterans General Hospital , Taipei , Taiwan , Republic of China.
authors.forename: Yu-Chin
authors.initials: YC
authors.lastname: Lee
authors.affiliation: e Taipei Cancer Center , Taipei Medical University , Taipei , Taiwan , Republic of China.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Whang-Peng
authors.affiliation: a Department of Chest Medicine , Taipei Veterans General Hospital , Taipei , Taiwan , Republic of China.|b School of Medicine , National Yang-Ming University , Taipei , Taiwan , Republic of China.|e Taipei Cancer Center , Taipei Medical University , Taipei , Taiwan , Republic of China.
authors.forename: Yuh-Min
authors.initials: YM
authors.lastname: Chen
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000235:genetics / Q000556:secondary; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018287:Carcinoma, Large Cell / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D019008:Drug Resistance, Neoplasm; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D016879:Salvage Therapy; D055752:Small Cell Lung Carcinoma / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D015996:Survival Rate
chemical_list: C512478:EGFR protein, human; D066246:ErbB Receptors
keywords: Adenocarcinoma; Epidermal growth factor receptor (EGFR); Tyrosine kinase inhibitors (TKIs)