Smoking History as a Predictor of Pemetrexed Monotherapy in Patients with Non-Squamous Non-Small Cell Lung Cancer

Igawa, Satoshi; Sasaki, Jiichiro; Otani, Sakiko; Shirasawa, Masayuki; Niwa, Hideyuki; Kusuhara, Seiichiro; Harada, Shinji; Kubota, Minoru; Katagiri, Masayuki; Masuda, Noriyuki

doi:10.1159/000446438

Cited by 8 publications

(8 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In previous studies, the adverse outcomes of smokers in chemotherapy have been confirmed. The study conducted by Igawa et al [50] showed that smoking history was a favorable predictor of efficacy of pemetrexed monotherapy in NSCLC, and long-term smoking history is associated with poor efficacy. After treatment with cisplatin, adverse outcomes of patients with testicular cancer were associated with smoking history [51].…”

Section: Discussionmentioning

confidence: 99%

Smokers or non-smokers: who benefits more from immune checkpoint inhibitors in treatment of malignancies? An up-to-date meta-analysis

et al. 2020

World J Surg Onc

View full text Add to dashboard Cite

Background: Immune checkpoint inhibitors, which are a milestone in anti-cancer therapy, have been applied in the treatment of multiple malignancies. Real-world data have suggested that smoking status may be associated with the efficacy of anti-PD-1/PD-L1 therapy. Hereby, to evaluate "smoking benefit or not", we included numerous high-quality randomized controlled clinical trials (RCTs) without any restriction on category. Methods: A systematic search of online database was performed from July 2010 to July 2019. Eligible studies included phase II/III RCTs comparing PD-1/PD-L1 inhibitors with chemotherapy in the treatment of multiple carcinomas and contained subgroup analysis of smoking status. Then, related hazard ratios (HRs) with 95% confidence intervals (CIs) of overall survival (OS) were pooled.Results: In the initial meta-analysis, compared with chemotherapy, the OS of non-smokers (HR, 0.81; 95% CI, 0.67-0.98) and smokers (HR, 0.77; 95% CI, 0.71-0.83) were significantly prolonged with PD-1/PD-L1 inhibitors. Outcomes from subgroup analysis showed that in anti-PD-1/PD-L1 monotherapy groups, non-smokers showed no significant improvement in OS (HR, 0.94; 95% CI, 0.83-1.06), while the OS of smokers was significantly prolonged (HR, 0.79; 95% CI, 0.74-0.85); in groups of PD-1/PD-L1 inhibitors combined with chemotherapy, the OS of non-smokers (HR, 0.45; 95% CI, 0.28-0.71) and smokers (HR, 0.72; 95% CI, 0.61-0.85) were significantly prolonged. Combined ipilimumab and chemotherapy showed no significance in both groups. Conclusion:Smokers benefit from either anti-PD-1/PD-L1 monotherapy or the combined regimen compared with chemotherapy. Considering cost-effectiveness, monotherapy was recommended to smokers. For non-smokers, only the combined regimen was feasible in non-small cell lung cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

Smokers or non-smokers: who benefits more from immune checkpoint inhibitors in treatment of malignancies? An up-to-date meta-analysis

et al. 2020

World J Surg Onc

View full text Add to dashboard Cite

show abstract

“…[ 20 , 21 ] Smoking status also affects the response to conventional chemotherapy, with nonsmokers achieving better response rates to pemetrexed than smokers. [ 22 ] Nevertheless, the predictors of response to EGFR-TKI remain controversial. [ 23 ] Therefore, improving the prediction of the efficacy of EGFR-TKI drugs is a current problem needing to be solved.…”

Section: Introductionmentioning

confidence: 99%

Impact of heavy smoking on the benefits from first-line EGFR-TKI therapy in patients with advanced lung adenocarcinoma

Zhang

Nie²,

Bie

et al. 2018

Medicine

View full text Add to dashboard Cite

Smoking is a risk factor for nonsmall cell lung carcinoma (NSCLC) and is associated with a lower response to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKI). The purpose of this study is to examine the impact of the smoking status on the benefits from first-line EGFR-TKI in NSCLC patients with EGFR mutation.This was a retrospective study of 159 patients with advanced NSCLC treated at the Beijing Hospital between January 2011 and December 2016. The follow-up was censored on December 2017. EGFR mutation status, smoking (nonsmoker vs <30 packs/year (light smoker) vs ≥30 packs/year (heavy smoker)), treatment, treatment response, and progression-free survival (PFS) were collected from the charts.Median follow-up was 10.0 (1.0–36.6) months. Response rate was lower in heavy smokers compared with nonheavy smokers (19.0% vs 71.7%, P < .001). There was no difference in PFS between nonsmokers (median, 10.5 months) and light smoker (median, 11.0 months), and these 2 groups were pooled together. PFS was longer in nonheavy smokers compared with heavy-smokers (median, 10.7 vs 6.0 months, P < .001). Smoking ≥ 30 packs/year (HR = 2.48, 95% CI: 1.55–3.98, P < .001) was associated with PFS.In patients with advanced NSCLC, the benefits and PFS of EGFR-TKI were better for nonheavy smokers than for heavy smokers.

show abstract

“…Our data was consistent with that of Igawa et al . in which smoking status was used as a predictor for pemetrexed chemotherapy regimens in wild‐type NSCLC patients . A possible explanation for the relationship between smoking status and survival is the expression of thymidylate synthase (TS).…”

Section: Discussionmentioning

confidence: 99%

Comparing first‐line treatment patterns and clinical outcomes of patients with pan‐negative advanced non‐squamous non‐small cell lung cancer

Zhu

et al. 2018

Thoracic Cancer

View full text Add to dashboard Cite

BackgroundPlatinum‐based chemotherapy is the standard first‐line treatment for patients with advanced pan‐negative non‐squamous (non‐Sq) non‐small cell lung cancer (NSCLC). However, it is unknown which chemotherapy regimen confers the greatest benefit in such patients. This study explored which chemotherapy regimens were advantageous in non‐Sq NSCLC patients.MethodsA retrospective study was conducted on 114 patients with advanced non‐Sq NSCLC using platinum‐based chemotherapy in a first‐line setting between January 2013 and December 2015. The study evaluated the most common first‐line regimens including pemetrexed/platinum (PP), paclitaxel/carboplatin, gemcitabine/platinum, and vinorelbine/cisplatin. The primary endpoint was progression‐free survival (PFS), and secondary endpoints were the objective response rate and disease control rate (DCR). Univariate and multivariate logistic analysis was carried out.ResultsSixty of the 114 patients were administered PP regimens and 54 non‐pemetrexed plus platinum (NPP) regimens. The median PFS was significantly longer in the PP than in the NPP group (7.2 months, 95% confidence interval [CI] 5.3–9.1 vs. 4.9 months, 95% CI 3.2–6.6; P = 0.031). The DCR of the PP regimen was better than that of the NPP regimen (90.0% vs. 74.1%; P = 0.026). Smoking status was an independent predictor of PFS (hazard ratio 2.1, 95% CI 1.4–3.3; P = 0.001) in a final multivariate Cox regression model.ConclusionsA PP regimen tends to be more beneficial than an NPP regimen for patients with pan‐negative advanced non‐Sq NSCLC. Smoking status may be a valuable predictor for the selection of a chemotherapy regimen in such patients.

show abstract

Smoking History as a Predictor of Pemetrexed Monotherapy in Patients with Non-Squamous Non-Small Cell Lung Cancer

Cited by 8 publications

References 41 publications

Smokers or non-smokers: who benefits more from immune checkpoint inhibitors in treatment of malignancies? An up-to-date meta-analysis

Smokers or non-smokers: who benefits more from immune checkpoint inhibitors in treatment of malignancies? An up-to-date meta-analysis

Impact of heavy smoking on the benefits from first-line EGFR-TKI therapy in patients with advanced lung adenocarcinoma

Comparing first‐line treatment patterns and clinical outcomes of patients with pan‐negative advanced non‐squamous non‐small cell lung cancer

Contact Info

Product

Resources

About