Third-generation EGFR-TKI plus pemetrexed-platinum chemotherapy versus TKI monotherapy as first-line treatment for EGFR-mutant lung adenocarcinoma with brain parenchymal metastases
4 affiliations
- 1Department of Head, Neck and Thoracic Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine-Hebei
- 2Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer
- 3Department of Thoracic Oncology, Tianjin Lung Cancer Center, Tianjin’s Clinical Research Center for Cancer, Tianjin Cancer Institute & Hospital, Tianjin Medical University
- 4Department of Urology, The Fifth People’s Hospital of Hengshui City
Abstract
Objective: To evaluate the efficacy and safety of first-line third-generation EGFR-tyrosine kinase inhibitor (EGFR-TKI) combined with pemetrexed-platinum chemotherapy in patients with EGFR-mutant advanced lung adenocarcinoma and brain parenchymal metastases.
Methods: A bicenter retrospective cohort study was conducted. A total of 150 eligible patients were enrolled and balanced by 1:1 propensity score matching. Tumor response, survival outcomes, and treatment-related adverse events were compared between groups.
Results: After matching, 60 patients were assigned to each group. The intracranial objective response rate was 78.3% in the combination group versus 61.7% in the monotherapy group (P = 0.046). The median intracranial progression-free survival was 28.3 months in the combination group (hazard ratio = 0.536, 95% confidence interval: 0.350–0.820, P = 0.002). Systemic progression-free survival and overall survival were also significantly prolonged in the combination arm. Adverse events were predominantly chemotherapy-related toxicities and were generally manageable.
Conclusion: First-line third-generation EGFR-TKI plus pemetrexed-platinum chemotherapy is associated with superior intracranial and systemic survival benefits in EGFR-mutant lung adenocarcinoma patients with brain parenchymal metastases, with a favorable safety profile. This study provides real-world evidence to support clinical treatment decision-making.
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BibTeX
@article{zhou2026thirdgeneration,
title = {{Third-generation EGFR-TKI plus pemetrexed-platinum chemotherapy versus TKI monotherapy as first-line treatment for EGFR-mutant lung adenocarcinoma with brain parenchymal metastases}},
author = {Jianxi Zhou and Yinghao Wang and Kang Wen and Chun Huang and Tingting Qin and Yunchuan Sun and Peng Chen},
journal = {Frontiers in Pharmacology},
year = {2026},
month = oct,
doi = {10.3389/fphar.2026.1959801},
url = {https://www.frontiersin.org/articles/10.3389/fphar.2026.1959801/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Third-generation EGFR-TKI plus pemetrexed-platinum chemotherapy versus TKI monotherapy as first-line treatment for EGFR-mutant lung adenocarcinoma with brain parenchymal metastases
AU - Jianxi Zhou
AU - Yinghao Wang
AU - Kang Wen
AU - Chun Huang
AU - Tingting Qin
AU - Yunchuan Sun
AU - Peng Chen
PY - 2026
DA - 2026/10/07
JO - Frontiers in Pharmacology
DO - 10.3389/fphar.2026.1959801
UR - https://www.frontiersin.org/articles/10.3389/fphar.2026.1959801/full
AB - Objective: To evaluate the efficacy and safety of first-line third-generation EGFR-tyrosine kinase inhibitor (EGFR-TKI) combined with pemetrexed-platinum chemotherapy in patients with EGFR-mutant advanced lung adenocarcinoma and brain parenchymal metastases. Methods: A bicenter retrospective cohort study was conducted. A total of 150 eligible patients were enrolled and balanced by 1:1 propensity score matching. Tumor response, survival outcomes, and treatment-related adverse events were compared between groups. Results: After matching, 60 patients were assigned to each group. The intracranial objective response rate was 78.3% in the combination group versus 61.7% in the monotherapy group (P = 0.046). The median intracranial progression-free survival was 28.3 months in the combination group (hazard ratio = 0.536, 95% confidence interval: 0.350–0.820, P = 0.002). Systemic progression-free survival and overall survival were also significantly prolonged in the combination arm. Adverse events were predominantly chemotherapy-related toxicities and were generally manageable. Conclusion: First-line third-generation EGFR-TKI plus pemetrexed-platinum chemotherapy is associated with superior intracranial and systemic survival benefits in EGFR-mutant lung adenocarcinoma patients with brain parenchymal metastases, with a favorable safety profile. This study provides real-world evidence to support clinical treatment decision-making.
SN - 1663-9812
ER -