First‐line pemetrexed/carboplatin or cisplatin/bevacizumab compared with paclitaxel/carboplatin/bevacizumab in patients with advanced non‐squamous non‐small cell lung cancer with wild‐type driver genes: A real‐world study in China

摘要

The study was conducted to compare the effectiveness and safety of pemetrexed/carboplatin or cisplatin/bevacizumab (PemPBev) and paclitaxel/carboplatin/bevacizumab (PacCBev) as first-line therapy for advanced non-squamous non-small cell lung cancer (NS-NSCLC) patients with wild-type driver genes in a real-world setting. We retrospectively collected the medical records of advanced NS-NSCLC patients with wild-type driver genes administered first-line PemPBev or PacCBev therapy at Shanghai Chest Hospital between January 2014 and June 2016, and analyzed the differences in survival outcomes, efficacy, and safety between PemPBev and PacCBev treatment. A total of 390 patients were included in our analysis: 249 in the PemPBev group and 141 in the PacCBev group. Patients administered PemPBev experienced significantly improved progression-free survival (PFS) and overall survival (OS) compared to those administered PacCBev (PFS 7.5 vs. 6.2?months, hazard ratio [HR] 0.66, 95% confidence interval [CI] 0.53-0.84, P ?0.001; OS:18.6 vs. 16.0?months, HR?0.68, 95% CI 0.52-0.90, P =?0.002). The objective response rate (ORR) and disease control rate (DCR) were similar between the groups (ORR 21.7% vs. 30.5%, P?=?0.053; DCR 69.1% vs. 67.4%, P =?0.728). There was no significant difference in the incidence of adverse events between the groups (64.7% vs. 68.8%; P =?0.407), but the incidence of peripheral neuropathy in the PacCBev group was higher than in the PemPBev group (7.8% vs. 2.4%; P =?0.012). Our study shows that for advanced NS-NSCLC patients with wild-type driver genes, first-line PemPBev might be a better treatment option compared to PacCBev. ? 2019 The Authors. Thoracic Cancer published by China Lung Oncology Group and John Wiley & Sons Australia, Ltd.