Huang Xin-En, Tian Guang-Yu, Cao Jie, Xu Xia, Lu Yan-Yan, Wu Xue-Yan, Liu Jin, Shi Lin, Xiang Jin
Department of Chemotherapy, the Affiliated Jiangsu Cancer Hospital of Nanjing Medical University and Jiangsu Institute of Cancer Research, Nanjing, China E-mail :
Asian Pac J Cancer Prev. 2014 Jan;14(11):6663-7. doi: 10.7314/apjcp.2013.14.11.6663.
The current research was conducted to investigate the efficacy and safety of pemetrexed given continuously as a basement agent for first-, second- to third line chemotherapy of patients with metastatic lung adenocarcinoma.
Patients with metastatic lung adenocarcinoma who were diagnosed in Jiangsu Cancer Hospital and Research Insitute, were enrolled. All received pemetrexed 500 mg/m2 (intravenous; on day 1), and another chemotherapieutic agent every 3 weeks until disease progression, or intolerable toxicity. Then the patients were changed to a second line chemotherapy that was still based on pemetrexed 500 mg/m2 and another chemotherapeutic agent differing from the first line example, until disease progression, or intolerable toxicity. When third line chemotherapy was needed, pemetrexed 500 mg/m2 and another new chemotherapeutic agent were combined until disease progression. Evaluation of efficacy was conducted after two cycles of chemotherapy using the Response Evaluation Criteria for Solid Tumors. Toxicity was recorded according to NCI Criteria for Adverse Events version 3.0.
From January 2010 to September 2013, 15 patients were enrolled. Their median age was 56 years (range 43 to 77 years). Eight patients were male and 7 female. Five patients (33.3%) achieved PR, while 6 patients (40.0%) remained stable, no CR on first line; and 1 PR (7.7%), 5 stable (38.5%) were recorded when pemetrexed was ordered in second line; 5 patients (41.7%) were stable after pemetrexed was combined in third line; no complete response was observed. Main side effects were grade 1 to 2 neutrophil suppression and thrombocytopenia. Other toxicities included elevated transaminase and oral mucositis, but no treatment related death occurred.
Pemetrexed continuously as a basement agent from first-, second- to third line chemotherapy is mildly effective in treating patients with metastatic lung adenocarcinoma with tolerable toxicity.
开展本研究以调查培美曲塞作为基础用药持续用于转移性肺腺癌患者一线、二线至三线化疗的疗效和安全性。
纳入在江苏省肿瘤医院及研究所确诊的转移性肺腺癌患者。所有患者均接受培美曲塞500mg/m²（静脉注射；第1天），每3周联合另一种化疗药物，直至疾病进展或出现不可耐受的毒性。然后患者更换为二线化疗方案，仍以培美曲塞500mg/m²为基础，联合一种与一线方案不同的化疗药物，直至疾病进展或出现不可耐受的毒性。当需要三线化疗时，联合培美曲塞500mg/m²和另一种新的化疗药物，直至疾病进展。化疗两个周期后，依据实体瘤疗效评价标准评估疗效。根据美国国立癌症研究所不良事件标准第3.0版记录毒性反应。
2010年1月至2013年9月，共纳入15例患者。他们的中位年龄为56岁（范围43至77岁）。8例为男性，7例为女性。5例患者（33.3%）达到部分缓解（PR），6例患者（40.0%）病情稳定，一线治疗无完全缓解（CR）；二线使用培美曲塞时，记录到1例PR（7.7%），5例稳定（38.5%）；三线联合培美曲塞后，5例患者（41.7%）病情稳定；未观察到完全缓解。主要副作用为1至2级中性粒细胞减少和血小板减少。其他毒性反应包括转氨酶升高和口腔黏膜炎，但未发生与治疗相关的死亡。
培美曲塞持续作为基础用药用于一线、二线至三线化疗，对转移性肺腺癌患者有一定疗效，毒性可耐受。
