{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:42:34Z","timestamp":1747190554037,"version":"3.40.5"},"reference-count":37,"publisher":"Wiley","license":[{"start":{"date-parts":[[2021,4,20]],"date-time":"2021-04-20T00:00:00Z","timestamp":1618876800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Computational and Mathematical Methods in Medicine"],"published-print":{"date-parts":[[2021,4,20]]},"abstract":"<jats:p>Object. This study is aimed at evaluating the efficacy and safety of pemetrexed and gefitinib in the treatment of non-small-cell lung cancer (NSCLC). Methods. Databases, including PubMed, the Cochrane Library, Embase, CNKI, and Web of Science, were applied to search for randomized controlled trials (RCTs) about the use of pemetrexed and gefitinib in the second-line treatment of locally advanced and metastatic NSCLC from database foundation to April 2020. Meta-analysis was conducted using the RevMan 5.3 software. Primary outcomes included progression-free survival (PFS) and overall survival (OS), and secondary outcomes included objective response rate (ORR), disease control rate (DCR), and all grades of drug-related adverse events (AEs). Results. Totally, 14 RCTs and 1,334 patients were involved in the study. The results of meta-analysis showed that compared with pemetrexed, gefitinib was not superior in improving ORR (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>P<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.21<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>), DCR (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>P<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.52<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>), PFS (<jats:inline-formula>\n                     <e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\">\n                        <e:mi>P<\/e:mi>\n                        <e:mo>=<\/e:mo>\n                        <e:mn>0.41<\/e:mn>\n                     <\/e:math>\n                  <\/jats:inline-formula>), and OS (<jats:inline-formula>\n                     <g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\">\n                        <g:mi>P<\/g:mi>\n                        <g:mo>=<\/g:mo>\n                        <g:mn>0.79<\/g:mn>\n                     <\/g:math>\n                  <\/jats:inline-formula>). Subgroup analysis showed that in patients with mutant EGFR (<jats:inline-formula>\n                     <i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\">\n                        <i:mi>P<\/i:mi>\n                        <i:mo>=<\/i:mo>\n                        <i:mn>0.08<\/i:mn>\n                     <\/i:math>\n                  <\/jats:inline-formula>) and wild-type EGFR (<jats:inline-formula>\n                     <k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\">\n                        <k:mi>P<\/k:mi>\n                        <k:mo>=<\/k:mo>\n                        <k:mn>0.80<\/k:mn>\n                     <\/k:math>\n                  <\/jats:inline-formula>), both pemetrexed and gefitinib produced a similar effect on PFS. In terms of safety, the incidence of rash (<jats:inline-formula>\n                     <m:math xmlns:m=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\">\n                        <m:mi>P<\/m:mi>\n                        <m:mo>&lt;<\/m:mo>\n                        <m:mn>0.00001<\/m:mn>\n                     <\/m:math>\n                  <\/jats:inline-formula>) and diarrhea (<jats:inline-formula>\n                     <o:math xmlns:o=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\">\n                        <o:mi>P<\/o:mi>\n                        <o:mo>=<\/o:mo>\n                        <o:mn>0.0005<\/o:mn>\n                     <\/o:math>\n                  <\/jats:inline-formula>) in the gefitinib group was significantly higher than those in the pemetrexed group, while the occurrence of neutropenia (<jats:inline-formula>\n                     <q:math xmlns:q=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\">\n                        <q:mi>P<\/q:mi>\n                        <q:mo>=<\/q:mo>\n                        <q:mn>0.01<\/q:mn>\n                     <\/q:math>\n                  <\/jats:inline-formula>) and fatigue (<jats:inline-formula>\n                     <s:math xmlns:s=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\">\n                        <s:mi>P<\/s:mi>\n                        <s:mo>=<\/s:mo>\n                        <s:mn>0.02<\/s:mn>\n                     <\/s:math>\n                  <\/jats:inline-formula>) was significantly lower. Conclusion. Gefitinib and pemetrexed showed similar efficacy and safety, regardless of the type of EGFR. Both gefitinib and pemetrexed can be used as conventional drugs for the second-line treatment of locally advanced and metastatic NSCLC.<\/jats:p>","DOI":"10.1155\/2021\/5534823","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T21:18:01Z","timestamp":1619039881000},"page":"1-11","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Pemetrexed and Gefitinib in the Treatment of Non-Small-Cell Lung Cancer: A Meta-Analysis"],"prefix":"10.1155","volume":"2021","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1805-1802","authenticated-orcid":true,"given":"Zhihao","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Thoracic Surgery, China Coast Guard Hospital of the People\u2019s Armed Police Force, Jiaxing, 314000 Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6143-0456","authenticated-orcid":true,"given":"Xiyong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, China Coast Guard Hospital of the People\u2019s Armed Police Force, Jiaxing, 314000 Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6139-5710","authenticated-orcid":true,"given":"Huaiqing","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, China Coast Guard Hospital of the People\u2019s Armed Police Force, Jiaxing, 314000 Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7744-3342","authenticated-orcid":true,"given":"Dongqiang","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, China Coast Guard Hospital of the People\u2019s Armed Police Force, Jiaxing, 314000 Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2128-6012","authenticated-orcid":true,"given":"Dongliang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, China Coast Guard Hospital of the People\u2019s Armed Police Force, Jiaxing, 314000 Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8624-3702","authenticated-orcid":true,"given":"Qun","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Thoracic Surgery, China Coast Guard Hospital of the People\u2019s Armed Police Force, Jiaxing, 314000 Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8263-1831","authenticated-orcid":true,"given":"Linna","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Pathology, First Affiliated Hospital of Jiaxing University, Jiaxing, 314000 Zhejiang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21654"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1097\/JTO.0000000000000630"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1093\/annonc\/mdw271"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30958-8"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1111\/1759-7714.12827"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1007\/s12032-015-0660-5"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2016.0031"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1158\/1078-0432.CCR-15-2266"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1016\/j.lungcan.2016.06.008"},{"key":"10","doi-asserted-by":"publisher","DOI":"10.7150\/jca.23356"},{"key":"11","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2008.10.026"},{"key":"12","doi-asserted-by":"publisher","DOI":"10.1016\/j.pulmoe.2019.06.001"},{"key":"13","doi-asserted-by":"crossref","DOI":"10.1002\/9780470712184","article-title":"Naunyn-Schmiedebergs Archiv f\u00fcr experimentelle Pathologie und Pharmakologie","volume":"5","author":"J. 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