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Before immune checkpoint blocking therapy, maintenance therapy with pemetrexed after chemotherapy is the standard treatment for patients with advanced non-squamous non-small cell lung cancer (NSQ- NSCLC ), and this is still the case when immunotherapy is not applicable
.
Recently, the results of a combined analysis study were published in the Journal of Clinical Lung Cancer.
Before immune checkpoint blocking therapy, maintenance therapy with pemetrexed after chemotherapy is the standard treatment for patients with advanced non-squamous non-small cell lung cancer (NSQ- NSCLC ), and this is still the case when immunotherapy is not applicable
Data from 4 randomized clinical trials (PARAMOUNT, PRONOUNCE, PointBreak, JVBL) of NSQ-NSCLC patients receiving pemetrexed +/- anti-VEGF maintenance therapy were combined and divided into two groups (Group A: Pemetrexed single agent Maintenance, n=486; Group B: Pemetrexed + anti-VEGF maintenance group, n=329)
.
The OS and treatment-related adverse events (TEAEs) of the two groups were analyzed by treatment time
Data from 4 randomized clinical trials (PARAMOUNT, PRONOUNCE, PointBreak, JVBL) of NSQ-NSCLC patients receiving pemetrexed +/- anti-VEGF maintenance therapy were combined and divided into two groups (Group A: Pemetrexed single agent Maintenance, n=486; Group B: Pemetrexed + anti-VEGF maintenance group, n=329)
Research group
Research groupMost patients have adenocarcinoma (only pemetrexed maintenance treatment, 85.
0%; pemetrexed + anti-VEGF, 81.
5%), stage IV disease (only pemetrexed maintenance, 92.
0%; pemetrexed + Anti-VEGF, 89.
4%), ECOG PS is 1 or 2 (Pemetrexed only maintains 59.
7%; Pemetrexed + anti-VEGF, 54.
4%)
.
Most patients were smokers in the past (pemetrexed only for maintenance, 77.
Most patients have adenocarcinoma (only pemetrexed maintenance treatment, 85.
The median OS of the pemetrexed single-agent maintenance group was 16.
Comparison of the two groups of OS
Comparison of the two groups of OSSubgroup analysis found that only patients with liver metastasis could benefit from pemetrexed + anti-VEGF maintenance, and there was no statistical difference between the two maintenance treatments in other subgroups
.
.
Only the subgroup of patients with liver metastasis can benefit from the maintenance of pemetrexed + anti-VEGF, and there is no statistical difference between the two maintenance treatments in the other subgroups
Subgroup analysis
Subgroup analysisThe most common TEAEs of any grade in patients in the pemetrexed maintenance group ( incidence ≥20% during the entire treatment cycle ) were nausea, fatigue, vomiting, anemia, neutropenia, constipation, decreased appetite, fatigue, Peripheral edema and insomnia
.
The most common grade 3-5 TEAEs are neutropenia, anemia, fatigue, vomiting, and fatigue . The most common TEAEs of any grade in patients in the pemetrexed maintenance group ( incidence ≥20% during the entire treatment cycle ) were nausea, fatigue, vomiting, anemia, neutropenia, constipation, decreased appetite, fatigue, Peripheral edema and insomnia
In the pemetrexed + anti-VEGF maintenance group, the most common TEAEs (incidence ≥20% during the entire treatment cycle) included fatigue, nausea, anemia, constipation, neutropenia, thrombocytopenia, decreased appetite, nose Bleeding, vomiting, cough, diarrhea, dyspnea, back pain, headache, dizziness, dyspnea, dehydration, leukopenia, high blood pressure, proteinuria, peripheral edema, and depression
In summary, studies have shown that in NSQ-NSCLC patients, there is no significant difference in OS between pemetrexed single-agent maintenance and pemetrexed + anti-VEGF maintenance, and the dual-agent maintenance group has higher adverse reactions
Original source:
Edward B.
Garon, Patrick Peterson, Maria Teresa Rizzo, Jong Seok Kim.
Overall Survival and Safety With Pemetrexed/Platinum +/-Anti-VEGF Followed by Pemetrexed +/- Anti-VEGF Maintenance in Advanced Nonsquamous Non-Small-Cell Lung Cancer : A Pooled Analysis of Four Randomized Studies.
Clinical Lung Cancer.
2021.
DOI: https://doi.
org/10.
1016/j.
cllc.
2021.
10.
010.
Garon, Patrick Peterson, Maria Teresa Rizzo, Jong Seok Kim.
Overall Survival and Safety With Pemetrexed/Platinum +/-Anti-VEGF Followed by Pemetrexed +/- Anti-VEGF Maintenance in Advanced Nonsquamous Non-Small-Cell Lung Cancer : A Pooled Analysis of Four Randomized Studies.
Clinical Lung Cancer.
2021.
DOI: https://doi.
org/10.
1016/j.
cllc.
2021.
10.
010.
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