Abstract:

Objective To compare the clinical efficacy of cisplatin therapy involving either pemetrexed  or docetaxel in stage Ⅳ lung adenocarcinoma with unkown epidermal growth factor receptor (EGFR) mutation status. Methods Medical records were collected and analyzed for 147 stage Ⅳ lung adenocarcinoma patients from January 2011 to December 2015. Propensity-score matching (PSM) were performed to further adjust for confounding factors, and then compared the efficacy and safety between pemetrexed plus cisplatin group (PP group) and docetaxel plus cisplatin group(DP group). Results When PSM were performed, PP group and DP group showed similar objective response rates(60.0% vs 60.0%, χ²<0.001,P>0.999) and control rates(86.7% vs 82.5%,χ²=0.284,P=0.594)，then pemetrexed and cisplatin treatment led to longer median survival time(17.0 months vs 9.0 months, χ²=4.411,P=0.036), longer median progression free survival time(8.0 months vs 5.0 months,χ²=4.299,P=0.038), lower risk of death(HR=0.476,95%CI:0.282-0.805,P=0.006), and the rate of grade Ⅲ-Ⅳ neutropenia was lower(χ²=11.429,P=0.001). Conclusions PP regime show a  better  short-time outcome and prognosis compared with DP regime  in patients with  stage Ⅳ lung adenocarcinoma who unkown EGFR mutation status.

Key words: Lung neoplasms, Lung adenocarcinoma, Propensity score matching, Pemetrexed, Docetaxel, Epidermal growth factor receptor, Mutation