Author(s)

Saki Manabe¹, Fumihiro Oshita^1,2*, Shuji Murakami¹, Tetsuro Kondo¹, Haruhiro Saito¹, Takeshi Kaneko³, Kouzo Yamada¹

¹Department of Thoracic Oncology, Kanagawa Cancer Center, Yokohama, Japan.
²Department of General Medicine, Kanagawa Prefectural Ashigarakami-Hospital, Matsuda, Japan.
³Department of Pulmonology, Yokohama City University Graduate School of Medicine, Yokohama, Japan.

We conducted a phase II study of combination chemotherapy with carboplatin (Cb) and pemetrexed (Pem) followed by gefitinib (Gef) to determine the effects and toxicities in patients with non-small cell lung cancer (NSCLC) harboring sensitive EGFR mutation. Eligible patients received four courses of Cb at a dose corresponding to a target area under the curve equal to 6 mg/mL·min and 500 mg/m² Pem on day 1 every three to four weeks followed by sequential Gef 250 mg once a day until tumor progression. Sixteen of registered 28 patients responded to Cb and Pem combination. Twenty-seven patients received sequential Gef and 8 non-responders to Cb and Pem achieved PR. The overall response rate was 85.7%. Among the major toxicities, grade 3 SGPT elevation, nausea and thrombosis were observed in 3, 3 and 1 patients, respectively, who received Cb and Pem, and grade 3 SGPT elevation and dry skin were observed in 5 and 1 patients, respectively, who received Gef. There was no febrile neutropenia and no treatment-related death. The median progression-free survival time was 19.1 months. Among 21 patients who were followed up for more than 2 years, 14 survived during that time. Cb and Pem followed by Gef maintenance are recommended for further evaluation for patients with metastatic NSCLC harboring sensitive EGFR mutation.

Pemetrexed, Gefitinib, EGFR Mutation, Non-Small Cell Lung Cancer, Chemotherapy

Manabe, S. , Oshita, F. , Murakami, S. , Kondo, T. , Saito, H. , Kaneko, T. and Yamada, K. (2015) Phase II Study of Carboplatin and Pemetrexed Followed by Gefitinib for Patients with Advanced Non-Small Cell Lung Cancer Harboring Sensitive EGFR Mutation. Journal of Cancer Therapy, 6, 1214-1222. doi: 10.4236/jct.2015.615132.