Cheng Linlin, Gao Emei, Zhu Fuxin, Wang Yuyan, Zhong Jia, An Tongtong
Dong'e County Hospital, Liaocheng 252200, China.
Peking University Cancer Hospital, Beijing 100142, China.
Zhongguo Fei Ai Za Zhi. 2019 Jun 20;22(6):395-400. doi: 10.3779/j.issn.1009-3419.2019.06.11.
Non-small cell lung cancer (NSCLC) accounts for about 85% of lung cancer, with a 5-year survival rate of less than 15%-19%, and more than 80% of the patients with lung cancer have progressed to advanced stage (Stage IIIb-IV) when they are clearly diagnosed. The comprehensive treatment mainly based on chemotherapy as the primary form is now considered as the major therapy method for advanced NSCLC without actionable driver gene mutations. Pemetrexed plus platinum doublet as well as single-agent pemetrexed are respectively the first-line major regimens recommended by guidelines and the second-line optional regimens. Yet the third-line treatment or beyond in advanced NSCLC is not evidence-based but conducted based on patients' previous medications, which is one of the most commonly used clinical methods. As pemetrexed is a multi-target chemotherapy drug with high efficiency but low toxicity, pemetrexed re-challenge strategy in advanced NSCLC is also a reasonable choice. We report one effective individual case that adopted pemetrexed re-challenge strategy in advanced NSCLC for three times, and at the same time conduct the relevant literature review.
非小细胞肺癌（NSCLC）约占肺癌的85%，5年生存率低于15%-19%，超过80%的肺癌患者在明确诊断时已进展至晚期（Ⅲb-Ⅳ期）。以化疗为主的综合治疗目前被认为是无可操作驱动基因突变的晚期NSCLC的主要治疗方法。培美曲塞联合铂类双药方案以及单药培美曲塞分别是指南推荐的一线主要方案和二线可选方案。然而，晚期NSCLC的三线及以上治疗并非基于循证医学，而是根据患者既往用药情况进行，这是最常用的临床方法之一。由于培美曲塞是一种高效低毒的多靶点化疗药物，晚期NSCLC中的培美曲塞再挑战策略也是一种合理选择。我们报告1例晚期NSCLC采用培美曲塞再挑战策略3次有效的个案，并同时进行相关文献复习。
