Pankaj Goyal, Ullas Batra, Doval Dinesh Chandra, Parveen Jain, Amitabh Upadhyay Kumar, Dash Prasanta Kumar, Akhil Jain, Agarwal Mohit, Rajat Bajaj
Department of Medical Oncology, Rajiv Gandhi Cancer Institute, Rohini, New Delhi, India.
South Asian J Cancer. 2016 Oct-Dec;5(4):196-203. doi: 10.4103/2278-330X.195345.
Lung cancer has been the most common cancer in the world for several decades. Pemetrexed is recommended as an option for the maintenance treatment in metastatic adenocarcinoma lung, if disease has not progressed immediately following platinum-based chemotherapy.
To study efficacy and toxicity profile of pemetrexed as a maintenance chemotherapeutic agent in patients with stage IV adenocarcinoma lung, not progressing after first line chemotherapy. Settings and Design: This was an observational, prospective. We enrolled patients with stage IV adenocarcinoma lung who has not progressed on first line chemotherapy, from September 2013 to August 2014 at a tertiary care cancer institute in North India.
In all, 108 patients with stage IV adenocarcinoma lung were started on induction pemetrexed/platinum chemotherapy. 60 patients with no disease progression & ECOG PS 0-2 were started on Pemetrexed maintenance. Progression free survival (PFS) and toxicity profile were recorded.
The mean number of maintenance cycles was 8.3 (range 2-28). 13 (21.6%) patients took >10 maintenance cycles. Pemetrexed maintenance therapy resulted in progression free survival (PFS) of 5.4 months. PFS on pemetrexed was consistent for all patient subgroups, including induction response: complete/partial responders (n-31) and stable disease (-29). 14 patients had grade III/IV adverse events with anemia being the most common in 3/60 patients (5%). 3 patients (5%) developed renal dysfunction out of which 1 was grade III.
Pemetrexed continuation maintenance chemotherapy is active and well tolerated. Pemetrexed maintenance should be considered in patients with advanced adenocarcinoma lung patients who have not progressed on completion of induction chemotherapy.
几十年来，肺癌一直是全球最常见的癌症。对于转移性肺腺癌，如果在铂类化疗后疾病未立即进展，培美曲塞被推荐作为维持治疗的一种选择。
研究培美曲塞作为维持化疗药物在IV期肺腺癌患者中的疗效和毒性特征，这些患者在一线化疗后病情未进展。设置与设计：这是一项观察性、前瞻性研究。我们于2013年9月至2014年8月在印度北部一家三级癌症护理机构招募了一线化疗后病情未进展的IV期肺腺癌患者。
总共108例IV期肺腺癌患者开始接受诱导培美曲塞/铂类化疗。60例病情无进展且东部肿瘤协作组体能状态（ECOG PS）为0 - 2的患者开始接受培美曲塞维持治疗。记录无进展生存期（PFS）和毒性特征。
维持治疗周期的平均次数为8.3次（范围2 - 28次）。13例（21.6%）患者接受了超过10个维持治疗周期。培美曲塞维持治疗导致无进展生存期为5.4个月。培美曲塞的PFS在所有患者亚组中是一致的，包括诱导反应：完全/部分缓解者（n = 31）和病情稳定者（n = 29）。14例患者发生III/IV级不良事件，其中贫血最为常见，60例患者中有3例（5%）。3例患者（5%）出现肾功能障碍，其中1例为III级。
培美曲塞持续维持化疗有效且耐受性良好。对于诱导化疗完成后病情未进展的晚期肺腺癌患者，应考虑采用培美曲塞维持治疗。
