title: Pemetrexed Versus Erlotinib in the Second-line Treatment of Patients with Advanced-stage Non-squamous NSCLC Harboring Wild-type EGFR Gene.
abstract: BACKGROUND
  Pemetrexed and erlotinib represent different agents commonly used for the second-line treatment of patients with advanced-stage non-small cell lung cancer (NSCLC).
  
  
  METHODS
  We analyzed data of 137 patients with advanced-stage non-squamous NSCLC treated with pemetrexed or erlotinib in the second line. All patients harbored a wild-type epidermal growth factor receptor gene. Genetic testing was performed using a combination of denaturing capillary electrophoresis and direct Sanger sequencing.
  
  
  RESULTS
  overall response rate and disease control rate in patients treated with pemetrexed was 20.8% and 62.5% vs. 6.3% and 53.2% in patients treated with erlotinib (p=0.022; p=0.358). Median progression-free and overall survival in patients treated with pemetrexed was 1.6 and 11.3 months vs. 1.9 and 11.4 months in patients treated with erlotinib (p=0.470 and p=0.942, respectively). Erlotinib was associated with skin rash and diarrhea; pemetrexed was associated with hematological toxicity and fatigue.
  
  
  CONCLUSIONS
  A similar efficacy and different, although well-tolerated, toxicity profile of both pemetrexed and erlotinib was shown.
authors.affiliation: Department of Oncology and Radiotherapy, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, Prague, Czech Republic Biomedical Center, Faculty of Medicine in Pilsen, Faculty of Sciences, Charles University in Prague, Prague, Czech Republic fiala.o@centrum.cz.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Fiala
authors.affiliation: Department of Pneumology, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, Prague, Czech Republic.
authors.forename: Milos
authors.initials: M
authors.lastname: Pesek
authors.affiliation: Department of Oncology and Radiotherapy, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, Prague, Czech Republic.
authors.forename: Jindrich
authors.initials: J
authors.lastname: Finek
authors.affiliation: Department of Pneumology, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, Prague, Czech Republic.
authors.forename: Martin
authors.initials: M
authors.lastname: Svaton
authors.affiliation: Center for Applied Genomics of Solid Tumours, Genomac Research Institute, Prague, Czech Republic Department of Analytical Chemistry, Faculty of Sciences, Charles University in Prague, Prague, Czech Republic.
authors.forename: Marek
authors.initials: M
authors.lastname: Minarik
authors.affiliation: Center for Applied Genomics of Solid Tumours, Genomac Research Institute, Prague, Czech Republic.
authors.forename: Lucie
authors.initials: L
authors.lastname: Benesova
authors.affiliation: Institute of Biostatistics and Analysis, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
authors.forename: Zbynek
authors.initials: Z
authors.lastname: Bortlicek
authors.affiliation: Department of Nuclear Medicine, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, Prague, Czech Republic.
authors.forename: Radek
authors.initials: R
authors.lastname: Kucera
authors.affiliation: Department of Nuclear Medicine, Medical School and Teaching Hospital in Pilsen, Charles University in Prague, Prague, Czech Republic.
authors.forename: Ondrej
authors.initials: O
authors.lastname: Topolcan
mesh_terms: D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000473:pathology; D066246:ErbB Receptors / Q000235:genetics*; D000069347:Erlotinib Hydrochloride / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000068437:Pemetrexed; D000069347:Erlotinib Hydrochloride; D066246:ErbB Receptors
keywords: NSCLC; Pemetrexed; chemotherapy; erlotinib; second-line treatment; targeted treatment