估计肌酐清除率与培美曲塞作为晚期非鳞状非小细胞肺癌延续维持治疗的疗效和毒性相关。

Estimated Creatinine Clearance Rate Is Associated With the Treatment Effectiveness and Toxicity of Pemetrexed As Continuation Maintenance Therapy for Advanced Nonsquamous Non-Small-Cell Lung Cancer.

作者信息

Chen Chung-Yu, Lin Jou-Wei, Huang Jenq-Wen, Chen Kuan-Yu, Shih Jin-Yuan, Yu Chong-Jen, Yang Pan-Chyr

机构信息

Division of Pulmonary Medicine, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan.

Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin County, Taiwan.

出版信息

Clin Lung Cancer. 2015 Nov;16(6):e131-40. doi: 10.1016/j.cllc.2015.01.001. Epub 2015 Jan 10.

DOI:10.1016/j.cllc.2015.01.001

PMID:25659505

Abstract

UNLABELLED

The purpose of this study was to explore the predictive factors of the effectiveness and treatment toxicity for pemetrexed as continuation maintenance therapy in patients with advanced nonsquamous non-small-cell lung cancer. Patients with an estimated creatinine clearance rate (Ccr) < 60 mL/min had a significantly longer survival. However, a decrease in estimated Ccr was associated with a increased risk of Grade 3/4 neutropenia and anemia.

BACKGROUND

PATIENTS AND METHODS

Patients with advanced nonsquamous NSCLC treated with pemetrexed as continuation maintenance therapy were enrolled. The medical records were reviewed and analyzed, including data on basic characteristics, estimated creatinine clearance rate (Ccr), treatment responses, progression-free survival (PFS), overall survival (OS), and treatment-related toxicities.

RESULTS

A total of 124 patients were included and all had adenocarcinoma. Patients with an estimated Ccr < 60 mL/min had a significantly longer PFS and OS (P = .045, and P = .006, respectively). Each 10 mL/min increase in estimated Ccr was associated with an increase of 9.8% in the risk of disease progression, and an increase of 9.2% in the risk of death. In contrast, an increase of 10 mL/min in estimated Ccr was associated with a decreased risk of Grade 3/4 neutropenia by 50.9% and anemia by 42.2%.

CONCLUSION

Estimated Ccr is helpful in predicting the effectiveness and treatment toxicities of pemetrexed maintenance therapy.

摘要

未标注

本研究的目的是探讨培美曲塞作为晚期非鳞状非小细胞肺癌患者持续维持治疗的有效性和治疗毒性的预测因素。估计肌酐清除率（Ccr）<60 mL/min的患者生存期明显更长。然而，估计Ccr的降低与3/4级中性粒细胞减少和贫血风险增加相关。

背景

本研究的目的是探讨培美曲塞作为晚期非鳞状非小细胞肺癌（NSCLC）患者持续维持治疗的有效性和治疗毒性的预测因素。

患者与方法

纳入接受培美曲塞作为持续维持治疗的晚期非鳞状NSCLC患者。回顾并分析病历，包括基本特征、估计肌酐清除率（Ccr）、治疗反应、无进展生存期（PFS）、总生存期（OS）以及治疗相关毒性的数据。

结果

共纳入124例患者，均为腺癌。估计Ccr<60 mL/min的患者PFS和OS明显更长（分别为P = .045和P = .006）。估计Ccr每增加10 mL/min，疾病进展风险增加9.8%，死亡风险增加9.2%。相反，估计Ccr每增加10 mL/min，3/4级中性粒细胞减少风险降低50.9%，贫血风险降低42.2%。