Department of Internal Medicine, Korea Cancer Center Hospital, 215-4, Gongneung-dong, Nowon-gu, Seoul, 139-706, Korea.
J Cancer Res Clin Oncol. 2010 Apr;136(4):547-52. doi: 10.1007/s00432-009-0687-0. Epub 2009 Sep 30.
Pemetrexed is a recognized active agent for the second-line treatment for advanced non-small cell lung cancer (NSCLC). This study was undertaken to evaluate the clinical benefits of pemetrexed and to identify patient characteristics that predict response to pemetrexed.
We retrospectively reviewed the medical records of patients with histologically proven stage IIIB or IV NSCLC who were treated with pemetrexed after the failure of prior chemotherapy.
The objective response rate for the 99 enrolled patients was 13.1% and 22 patients achieved stable disease (SD)-a disease control rate of 35.4%. Progression-free survival and overall survival (OS) were 1.8 months (95% CI, 1.32-2.28) and 7.6 months (95% CI, 6.23-8.97), respectively. The patients who achieved SD and pemetrexed-responders showed similar OSs (14.6 vs. 14.8 months, P = 0.55). However, a squamous cell carcinoma histology showed no significant OS difference between those that achieved disease control or progression (8.1 vs. 5.6 months, P = 0.07). Subgroup analysis of OS revealed that histology and response to first-line therapy predicted response to pemetrexed.
Pemetrexed has comparable survival benefits in NSCLC patients that show objective response or stable disease.
培美曲塞是晚期非小细胞肺癌(NSCLC)二线治疗的公认有效药物。本研究旨在评估培美曲塞的临床获益,并确定预测培美曲塞反应的患者特征。
我们回顾性分析了 99 例经组织学证实的 IIIB 或 IV 期 NSCLC 患者的病历,这些患者在先前的化疗失败后接受了培美曲塞治疗。
99 例入组患者的客观缓解率为 13.1%,22 例患者获得疾病稳定(SD)-疾病控制率为 35.4%。无进展生存期和总生存期(OS)分别为 1.8 个月(95%CI,1.32-2.28)和 7.6 个月(95%CI,6.23-8.97)。获得 SD 和培美曲塞缓解的患者的 OS 相似(14.6 与 14.8 个月,P=0.55)。然而,鳞状细胞癌组织学显示,在获得疾病控制或进展的患者中,OS 无显著差异(8.1 与 5.6 个月,P=0.07)。OS 的亚组分析显示,组织学和一线治疗的反应预测了对培美曲塞的反应。
培美曲塞在显示客观缓解或疾病稳定的 NSCLC 患者中具有相当的生存获益。