Clinical Oncology and Cancer Research

, Volume 8, Issue 4, pp 235–241

Pemetrexed monotherapy and pemetrexed plus platinum combination therapy as non-first-line treatments for advanced non-small cell lung cancer

  • Fang Wang
  • Gui-fang Guo
  • Hui-juan Qiu
  • Xu-xian Chen
  • Pi-li Hu
  • Fei-fei Zhou
  • Wen-zhuo He
  • Bei Zhang
  • Liang-ping Xia
Article

DOI: 10.1007/s11805-011-0587-3

Cite this article as:
Wang, F., Guo, G., Qiu, H. et al. Clin. Oncol. Cancer Res. (2011) 8: 235. doi:10.1007/s11805-011-0587-3
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Abstract

Objective

Data on the efficacy profiles of pemetrexed monotherapy and pemetrexed plus platinum combination therapy in the non-first-line setting for patients with advanced non-small cell lung cancer (NSCLC) are limited, and previous studies have reported contradictory results. This study investigated and compared the efficacy and toxicity profiles of these two regimens to provide a broader understanding of their dynamics.

Methods

Previously treated patients with advanced and/or recurrent NSCLC who received pemetrexed monotherapy or pemetrexed plus platinum combination therapy between January 1, 2006, and December 31, 2009, at Sun Yat-sen University Cancer Center were evaluated. The primary endpoint of this study was progression-free survival (PFS), whereas the secondary endpoints were overall response rate (ORR), disease control rate (DCR), overall survival (OS), and toxicity. Survival was analyzed using the Kaplan-Meier method. Univariate analysis was performed to identify the factors potentially influencing OS, and chi-square analysis was carried out to compare ORR and DCR.

Results

Forty-six patients with advanced and/or recurrent NSCLC were analyzed; of these patients, 25 were given pemetrexed monotherapy and 21 received pemetrexed plus platinum combination therapy. The following correspond to the rates recorded for the pemetrexed monotherapy group and the pemetrexed plus platinum group: median PFS, 1.97 and 2.3 months (P=0.565); median OS, 30. 93 and 30.33 months (P=0.877); ORR, 8% (2/25) and 9.5% (2/21) (P=0.857); and DCR, 32% (8/25) and 57.1% (12/21) (P=0.09). Univariate analysis revealed that no factor was correlated with OS from NSCLC (P>0.05 for all). Gastrointestinal toxicity in the pemetrexed plus platinum group was modestly higher than that in the pemetrexed monotherapy group (P=0.034), but other adverse events were similar between the groups.

Conclusion

Compared with pemetrexed monotherapy, pemetrexed plus platinum combination therapy causes more gastrointestinal toxicities and does not exhibit improved efficacy, in terms of ORR, DCR, PFS, and OS, in the non-first-line setting for NSCLC. However, further research with a higher patient population is necessary to validate this finding.

Key Words

pemetrexednon-small cell lung cancerefficacysafetynon-first-line setting

Abbreviations

NSCLC

non-small cell lung cancer

CR

complete response

PR

partial response

SD

stable disease

PD

progressive disease

ORR

overall response rate

DCR

disease control rate

OS

overall survival

PFS

progression-free survival

PS

performance status

EGFR

epidermal growth factor receptor

TKI

tyrosine kinase inhibitor

Copyright information

© Tianjin Medical University Cancer Institute and Hospital and Springer Berlin Heidelberg 2011

Authors and Affiliations

  • Fang Wang
    • 1
    • 2
  • Gui-fang Guo
    • 1
    • 2
  • Hui-juan Qiu
    • 1
    • 2
  • Xu-xian Chen
    • 1
    • 2
  • Pi-li Hu
    • 1
    • 2
  • Fei-fei Zhou
    • 3
  • Wen-zhuo He
    • 1
    • 2
  • Bei Zhang
    • 1
    • 2
  • Liang-ping Xia
    • 1
    • 2
  1. 1.State Key Laboratory of Oncology in South ChinaGuangzhouGuangdong Province, China
  2. 2.VIP RegionSun Yat-sen University Cancer CenterGuangzhouGuangdong Province, China
  3. 3.Tumor CenterThe Foshan First People’s HospitalFoshanGuangdong Province, China