Observation Of Efficacy And Safety Of Pemetrexed Plus Nedaplatin In Chemotherapy-naive Patients With Advanced Lung Adenocarcinoma

Objective:To investigate the clinical value of pemetrexed plus nedaplatin in the chemotherapy-naive patients with advanced lung adenocarcinoma.Methods:Patients diagnosed as ⅢB or Ⅳ lung adenocarcinoma in Respiratory Department of Shandong Provincial Hospital affiliated to Shandong University from January2012to January2013were collected. The disease was confirmed by pathologic and/or cytologic methods. The patients were collected into2groups according to the treatments:(1) Group I (experimental group):pemetrexed500mg/m2, nedaplatin80mg/m2, pretreated drugs included folic acid, Vitamin B12and dexamethasone;(2) Group II (control group):docetaxel75mg/m2, nedaplatin80mg/m2, pretreated drug included dexamethasone. The5-serotonin receptor inhibitors, proton pump inhibitors reducing gastrointestinal reactions and other supportive treatments were given during the chemotherapy.21days for one cycle in both groups. The efficacy was evaluated according to RECIST1.1after four treatment cycles. The adverse reactions were evaluated according to CTCAE4.0.Results:1. Efficacy:Group I:overall response rate(ORR)42.3%, disease control rate(DCR)84.6%; Group II:ORR43.3%, DCR83.3%, making no statistical difference;2. Subgroup analysis:gender, smoking, age did not make any differences to the ORR and DCR;3. Survival analysis:Two factors including treatment and gender were analyzed separately, indicating no statistical differences in overall PFS and OS;4. Adverse events:mainly included white blood cell reduction (30.8%) neutrophil reduction (34.6%), anemia (42.3%), platelet reduction (15.4%), nausea (42.3%), hair loss (38.5), malaise (38.5), and so on. Most of the adverse events were mild and tolerated. The incidence of white blood cell reduction, neutrophil reduction, platelet reduction and grade3-4adverse events in group I was lower than group Ⅱ, with statistical significance.Conclusions:Pemetrexed plus nedaplatin as treatments to chemotherapy-naive patients with advanced lung adenocarcinoma was effective, showed better safety and more expensive compared to docetaxel plus nedaplatin. Pemetrexed plus nedaplatin can be one of the preferred first-line treatments of patients with advanced lung adenocarcinoma who can afford, worthy of further clinical promotion.