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Efficacy and Toxicity of Maintenance Pemetrexed Following Induction Treatment with Pemetrexed Plus Cisplatin for Advanced Non-small-cell Non-squamous Carcinoma of the Lung


INTRODUCTION: The aim of this study is to assess the efficacy and toxicity of maintenance pemetrexed following induction treatment with cisplatin and pemetrexed for patients with advanced non-small cell lung cancer.

PATIENTS AND METHODS: Eligible patients following four cycles of intravenous pemetrexed (Alimpta©; 500 mg/m2) and intravenous cisplatin (75 mg/m2) were given 21-day cycles of maintenance pemetrexed (500 mg/m2) until disease progression, unacceptable adverse event or death. From a total 80 patients receiving palliative induction chemotherapy, 17 subsequently received maintenance pemetrexed.

RESULTS: The mean number of maintenance cycles completed was 5.9 (range 1-20; median 3.0). The mean progression-free survival (PFS) was 5.2 months (range: 2-15; median: 2.0) and the 1-year PFS was 17%. Treatment was discontinued due to disease progression (71%), adverse event (21%) and death from study disease (7%). Grade 3-4 laboratory and non-laboratory adverse events were seen in 11.8 and 17.6% of patients, respectively. Anaemia was the most common adverse event (71% of all patients; 65% grade 1-2; 5.9% grade 3-4). The most common reason for withdrawal due to adverse event was declining renal function. There was a statistically significant correlation between worsening performance status and reducing number of maintenance cycles completed (Spearman’s rank; R = −0.511, p = 0.036).

DISCUSSION: The median PFS was lower than in previous studies with a higher than previously reported frequency of adverse events. Clinicians must monitor renal function and full blood counts vigilantly, especially in patients with performance status greater than 0.

Calendario de la edición:
4 veces al año
Temas de la revista:
Medicine, Clinical Medicine, Internal Medicine, Haematology, Oncology