title: EGFR Mutation Genotype Impact on the Efficacy of Pemetrexed in Patients with Nonsquamous Nonsmall Cell Lung Cancer.
abstract: BACKGROUND
  Pemetrexed monotherapy has come to be recognized as one of the standard secondline therapies for advanced nonsquamous nonsmall cell lung cancer (NSCLC). However, there have been no reports of studies that have evaluated the efficacy of pemetrexed according to type of active EGFR mutation, i.e., an exon 19 deletion or an L858R point mutation.
  
  
  METHODS
  The records of nonsquamous NSCLC patients harboring an EGFR mutation who received pemetrexed monotherapy as a second or later line of chemotherapy at Kitasato University Hospital between March 2010 and October 2015 were retrospectively reviewed, and the treatment outcomes were evaluated.
  
  
  RESULTS
  The overall response rate and progressionfree survival time (PFS) of the 53 patients with nonsquamous NSCLC were 15.1% and 2.3 months, respectively. There were significant differences between the disease control rate (37.5% vs. 76.2%) and PFS time (1.8 months vs. 3.3 months) of the exon 19 deletion group and the L858R point mutation group, and a multivariate analysis identified type of EGFR mutation as well as performance status (PS) as independent predictors of PFS.
  
  
  CONCLUSIONS
  The clinical data obtained in this study provided a valuable rationale for considering type of EGFR mutation as well as non squamous histology as predictors of the efficacy of pemetrexed monotherapy.
authors: Department of Respiratory Medicine, Kitasato University School of Medicine, Kitasato, Minamiku, Sagamiharacity, Kanagawa, Japan Email : igawa@kitasatou.ac.jp.
authors: Satoshi
authors: S
authors: Igawa
authors: Yuichi
authors: Y
authors: Sato
authors: Mikiko
authors: M
authors: Ishihara
authors: Masashi
authors: M
authors: Kasajima
authors: Seiichiro
authors: S
authors: Kusuhara
authors: Yoshiro
authors: Y
authors: Nakahara
authors: Sakiko
authors: S
authors: Otani
authors: Tomoya
authors: T
authors: Fukui
authors: Masato
authors: M
authors: Katagiri
authors: Jiichiro
authors: J
authors: Sasaki
authors: Noriyuki
authors: N
authors: Masuda
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000235:genetics; D001932:Brain Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000556:secondary; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D066246:ErbB Receptors / Q000235:genetics*; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000235:genetics*; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D009367:Neoplasm Staging; D000068437:Pemetrexed / Q000627:therapeutic use*; D016133:Polymerase Chain Reaction; D011379:Prognosis; D015996:Survival Rate
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D000068437:Pemetrexed; C512478:EGFR protein, human; D066246:ErbB Receptors