| BACKGROUND:Pemetrexed is a multitargeted antifolate as a new antineoplastic drug. It could suppress the growth of tumor cells by blocking activities of three key enzymes in the purine and pyrimidine metabolic pathway. Malignant mesothelioma of pleura was the primary indication of pemetrexed. For a good antitumor function in Non-small-cell-lung-cancer (NSCLC) suggested by some trials and experiments, U.S. Food and Drug Administration (FDA) approved a new indication of pemetrexed (Alimta injection, Eli Lilly and Company by the United States R & D) on September 30,2008, which allow it as a first-line treatment in locally and metastasic non-squamous NSCLC with cisplatin.PURPOSE:Observe the recent clinical therapeutic effects and safety profile of the cisplatin plus pemetrexed combination as first-line chemotherapy in advanced NSCLC.METHODS:Forty-one naive locally advanced or metastatic NSCLC patients who had already diagnosed as adenocarcinoma by pathological examination were observed during the whole treatment and were followed up after their course. All patients received pemetrexed 500 mg/m2 on day 1, plus a total dose of cisplatin 75 mg/m2 from day 1 to day 3, repeated every 3 weeks. Evaluation of therapeutic efficiency and safety profile were underwent every 2 courses.RESULTS:Efficacy:all forty-one patients were eligible to evaluate their therapeutic efficiency. Seventeen patients had partial remission (PR),20 patients had stable disease (SD). There were no complete remission (CR) patient and 4 patients unfortunately had progressive disease (PD). The recently response rate(ORR) was 41.5%(17/41) with a 90.2%(37/41) disease control rate (DCR). In the subgroup analysis, ORR of smoking patients was 46.1%(6/13) versus a 39.3%(11/28) ORR in non-smoking patients(P=0.386). The ORR in female(5/22) is much lower than in male(12/19)[22.7% vs.63.1%](P=0.009). Safety:Overall,50.0% patients presented with grade 1-2 hematological toxic effects while 25.0%-27.5% patients presented grade 1-2 gastrointestinal adverse effects. Only 2 patients showed grade 3-4 neutropenia.CONCLUSION:Pemetrexed plus cisplatin is an effective and well-tolerated regimen as first-line therapy for patients with lung adenocarcinoma. The ORR was 41.5%(17/41),the DCR was 90.2%(37/41). According to subgroup analysis, efficacy in male is much better than female. |
