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Efficacy and Safety of Pemetrexed in Advanced Non-Small Cell Lung Carcinoma

진행성 비소세포폐암 환자에서 Pemetrexed의 효과와 안전성

  • Lee, Gyu Jin (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Jung, Mann Hong (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Jang, Tae Won (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Ok, Chul Ho (Department of Internal Medicine, Kosin University College of Medicine) ;
  • Jung, Hyun Joo (Department of Internal Medicine, Kosin University College of Medicine)
  • 이규진 (고신대학교 의과대학 내과학교실) ;
  • 정만홍 (고신대학교 의과대학 내과학교실) ;
  • 장태원 (고신대학교 의과대학 내과학교실) ;
  • 옥철호 (고신대학교 의과대학 내과학교실) ;
  • 정현주 (고신대학교 의과대학 내과학교실)
  • Received : 2009.06.20
  • Accepted : 2009.08.11
  • Published : 2009.08.30

Abstract

Background: Pemetrexed has been prescribed newly as a second line chemotherapy in advanced non-small cell lung carcinoma (NSCLC). The aim of study was to determine the efficacy and toxicity of pemetrexed in advanced NSCLC. Methods: Patients with histologically or cytologically confirmed NSCLC were evaluated from June 2006 to December 2008. The patients had relapsed or progressed after prior chemotherapy treatment. They were treated with intravenous pemetrexed $500mg/m^2$ for 10 min on Day 1 of each 21-day cycle. Results: A total of 89 patients were eligible for analysis. The response rate and disease control rate were 11% and 66%. Non-squamous cell carcinoma histology was significantly associated with a superior response rate (p=0.035) and disease control rate (p=0.009) than squamous cell carcinoma histology. The median survival time was 13 months and the median progression free survival time was 2.3 months. The median survival time of patients with ECOG PS 0~1 was 13.2 months, whereas median survival time was 11.6 months for patients with PS 2 (p=0.002). The median progression free survival time of patients with PS 0~1 were 3.8 months, but 2.1 months for patients with PS 2 (p=0.016). The median progression free survival time of smokers with non-squamous cell carcinoma was 3.4 months, which was significant (p=0.014). Grade 3~4 neutropenia were seen in 7.9% patients. Conclusion: Pemetrexed has efficacy in patients who had prior chemotherapy with advanced NSCLC and less hematologic toxicity.

Keywords

References

  1. Jemal A, Siegel R, Ward E, Hao Y, Xu J, Murray T, et al. Cancer statistics, 2008. CA Cancer J Clin 2008;58:71-96 https://doi.org/10.3322/CA.2007.0010
  2. Korea National Statistical Office. Annual report on the cause of death statistics, 2007. Daejeon: Korea National Statistical Office; 2008
  3. Herbst RS, Heymach JV, Lippman SM. Lung Cancer. N Engl J Med 2008;359:1367-80 https://doi.org/10.1056/NEJMra0802714
  4. Socinski MA, Morris DE, Masters GA, Lilenbaum R. Chemotherapeutic management of stage IV non-small cell lung cancer. Chest 2003;123:226S-43S https://doi.org/10.1378/chest.123.1_suppl.226S
  5. Socinski MA, Schell MJ, Peterman A, Bakri K, Yates S, Gitten R, et al. Phase III trial comparing a defined duration of therapy versus continuous therapy followed by second-line therapy in advanced-stage IIIB/IV nonsmall-cell lung cancer. J Clin Oncol 2002;20:1335-43 https://doi.org/10.1200/JCO.20.5.1335
  6. Thodtmann R, Depenbrock H, Dumez H, Blatter J, Johnson RD, van Oosterom A, et al. Clinical and phar-macokinetic phase I study of multitargeted antifolate (LY231514) in combination with cisplatin. J Clin Oncol 1999;17:3009-16 https://doi.org/10.1200/JCO.1999.17.10.3009
  7. Manegold C, Gatzemeier U, von Pawel J, Pirker R, Malayeri R, Blatter J, et al. Front-line treatment of advanced non-small-cell lung cancer with MTA (LY231514, pemetrexed disodium, ALIMTA) and cisplatin: a multicenter phase II trial. Ann Oncol 2000;11:435-40 https://doi.org/10.1023/A:1008336931378
  8. Shepherd FA, Dancey J, Arnold A, Neville A, Rusthoven J, Johnson RD, et al. Phase II study of pemetrexed disodium, a multitargeted antifolate, and cisplatin as first-line therapy in patients with advanced nonsmall cell lung carcinoma: a study of the National Cancer Institute of Canada Clinical Trials Group. Cancer 2001;92:595-600 https://doi.org/10.1002/1097-0142(20010801)92:3<595::AID-CNCR1359>3.0.CO;2-D
  9. Goedhals L, van Wiyk AL, Smith BL, Fourie SJ. Pemetrexed (Alimta LY231514) demonstrates clinical activity in chemonaive patients with cervical cancer in a phase II single-agent trial. Int J Gynecol Cancer 2006;16:1172-8 https://doi.org/10.1111/j.1525-1438.2006.00451.x
  10. Therasse P, Arbuck SG, Eisenhauer EA, Wanders J, Kaplan RS, Rubinstein L, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000;92:205-16 https://doi.org/10.1093/jnci/92.3.205
  11. Breathnach OS, Freidlin B, Conley B, Green MR, Johnson DH, Gandara DR, et al. Twenty-two years of phase III trials for patients with advanced non-smallcell lung cancer: sobering results. J Clin Oncol 2001;19:1734-42 https://doi.org/10.1200/JCO.2001.19.6.1734
  12. Shepherd FA, Dancey J, Ramlau R, Mattson K, Gralla R, O'Rourke M, et al. Prospective randomized trial of docetaxel versus best supportive care in patients with non-small-cell lung cancer previously treated with platinum-based chemotherapy. J Clin Oncol 2000;18:2095-103 https://doi.org/10.1200/JCO.2000.18.10.2095
  13. Shepherd FA, Rodrigues Pereira J, Ciuleanu T, Tan EH, Hirsh V, Thongprasert S, et al. Erlotinib in previously treated non-small-cell lung cancer. N Engl J Med 2005;353:123-32 https://doi.org/10.1056/NEJMoa050753
  14. Hanna N, Shepherd FA, Fossella FV, Pereira JR, De Marinis F, von Pawel J, et al. Randomized phase III trial of pemetrexed versus docetaxel in patients with nonsmall-cell lung cancer previously treated with chemotherapy. J Clin Oncol 2004;22:1589-97 https://doi.org/10.1200/JCO.2004.08.163
  15. Stinchcombe TE, Socinski MA. Considerations for second-line therapy of non-small cell lung cancer. Oncologist 2008;13 Suppl 1:28-36 https://doi.org/10.1634/theoncologist.13-S1-28
  16. Bearz A, Garassino I, Cavina R, Favaretto A, Boccalon M, Talamini R, et al. Pemetrexed single agent in previously treated non-small cell lung cancer: a multi-institutional observational study. Lung Cancer 2008;60:240-5 https://doi.org/10.1016/j.lungcan.2007.10.008
  17. Weiss GJ, Rosell R, Fossella F, Perry M, Stahel R, Barata F, et al. The impact of induction chemotherapy on the outcome of second-line therapy with pemetrexed or docetaxel in patients with advanced non-small-cell lung cancer. Ann Oncol 2007;18:453-60 https://doi.org/10.1093/annonc/mdl454
  18. Lee HY, Ahn MJ, Park YH, Ahn JS, Kim BS, Kim HK, et al. Adenocarcinoma has an excellent outcome with pemetrexed treatment in Korean patients: a prospective, multicenter trial. Lung Cancer. Forthcoming 2009
  19. Sun JM, Lee KW, Kim JH, Kim YJ, Yoon HI, Lee JH, et al. Efficacy and toxicity of pemetrexed as a third-line treatment for non-small cell lung cancer. Jpn J Clin Oncol 2009;39:27-32 https://doi.org/10.1093/jjco/hyn118

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