Brechot Jeanne-Marie, Morère Jean-François
Service d'oncologie médicale, Hôpital Avicenne, 125, route de Stalingrad, 93009 Bobigny Cedex.
Bull Cancer. 2007;94 Spec No Actualites:S139-41.
Efficacy of pemetrexed has been demonstrated in malignant pleural mesothelioma. This is based on the result of a phase III trial comparing cisplatin and pemetrexed to cisplatin alone, with a significant improvement of median survival in the doublet arm (11.4 versus 8.8 months, p = 0.048). This combination represents a new standard of chemotherapy in this disease. In non small cell lung cancer, pemetrexed has been compared as second line chemotherapy to docetaxel : efficacy was comparable (median survival of 8.3 months with pemetrexed and 7.9 months with docetaxel) but significant less hematological toxicity was observed in the pemetrexed arm compared to the docetaxel arm, especially grade 3-4 neutropenia (respectively 5.3 and 40.2%) and febrile neutropenia (1.9 versus 12.7%). The place of pemetrexed in elderly patients is under evaluation.
培美曲塞在恶性胸膜间皮瘤中的疗效已得到证实。这是基于一项III期试验的结果，该试验比较了顺铂联合培美曲塞与单用顺铂，双联用药组的中位生存期有显著改善（11.4个月对8.8个月，p = 0.048）。这种联合用药是该疾病化疗的新标准。在非小细胞肺癌中，培美曲塞作为二线化疗药物与多西他赛进行了比较：疗效相当（培美曲塞组中位生存期为8.3个月，多西他赛组为7.9个月），但与多西他赛组相比，培美曲塞组的血液学毒性明显更低，尤其是3-4级中性粒细胞减少（分别为5.3%和40.2%）以及发热性中性粒细胞减少（1.9%对12.7%）。培美曲塞在老年患者中的应用正在评估中。
