Clinical study comparing pemetrexed plus carboplatin with gemcitabine plus carboplatin as first-line treatment in patients with advanced nonsquamous non-small cell lung cancer

Abstract

Abstract: AIM: To observe the clinical efficacy and adverse effect of Pemetrexed combined with Carboplatin and Gemcitabine combined with Carboplatin to treat non-squamous non-small cell lung cancer.METHODS: 57 pathologically confirmed patients with ⅢB/Ⅳ staged NSCLC were recruited in this study. 26 patients treated with Pemetrexed plus Carboplatin (PC group) and 31 with Gemcitabine plus Carboplatin (GC group) more than 2 cycles.The latest clinical efficacy and adverse effect were evaluated.RESULTS: No statistical difference was observed in objective response rate(ORR) (42.3% vs 41.9%),disease control rate(88.5% vs 80.6%)and median progression free survival(PFS)(5.9 months vs 4.7 months) between the PC group and GC group. The main common adverse reactions were myelosuppression and gastrointestinal response in both groups.The rates of Ⅲ-Ⅳdegree thrombocytopenia were obviously less observed on the PC group compared with GC group.CONCLUSION: The both groups have similar clinical efficacy as the treatment of Nonsquamous NSCLC,but the Pemetrexed combined with Carboplatin has better safety and less reaction.

Key words: Non-small cell lung cancer, Pemetrexed, Gemcitabine, Carboplatin, Chemotherapy

CLC Number:

R734

CHEN Dong-yun, ZHAO Wen-ying, JI Zhao-ning. Clinical study comparing pemetrexed plus carboplatin with gemcitabine plus carboplatin as first-line treatment in patients with advanced nonsquamous non-small cell lung cancer[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2013, 18(12): 1401-1405.

References

[1] 张湘茹,王惠杰.肺癌[M] //孙燕,石远凯,主编,临床肿瘤内科学手册.5版.北京:人民卫生出版社,2007:414-419.
[2] 蔡利.晚期非小细胞肺癌内科治疗的优化选择[M] //秦叔逵,马军,吴一龙,主编,中国临床肿瘤学进展. 北京:人民卫生出版社,2012:72-75.
[3] Chattopadhyay S, Moran RG, Goldman ID,et al.Pemetrexed: biochemical and cellular pharmacology, mechanisms, and clinical applications[J]. Mol Cancer Ther,2007,6(2):404-417.
[4] Jiang J, Li L, Wang X, et al. A meta-analysis of pemetrexed plus platinum chemotherapy versus gemcitabine plus platinum chemotherapy for advanced non-small cell lung cancer[J]. Zhongguo Fei Ai Za Zhi,2011,14(1):43-48.
[5] Fleeman N, Bagust A, McLeod C,et al. Pemetrexed for the first-line treatment of locally advanced or metastatic non-small cell lung cancer[J]. Health Technol Assess, 2010,14 (Suppl 1):47-53.
[6] Zhang X, Lu J, Xu J, et al.Pemetrexed plus platinum or gemcitabine plus platinum for advanced non-small cell lung cancer: final survival analysis from a multicentre randomized phase II trial in the East Asia region and a meta-analysis[J]. Respirology,2013,18(1):131-139.
[7] Treat J, Scagliotti GV, Peng G, et al. Comparison of pemetrexed plus cisplatin with other first-line doublets in advanced non-small cell lung cancer (NSCLC): a combined analysis of three phase 3 trials[J]. Lung Cancer, 2012,76(2):222-227.
[8] Hanna N, Shepherd FA, Fossella FV,et al.Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy[J]. J Clin Oncol, 2004 ,22(9):1589-1597.
[9] Weiss GJ, Langer C, Rosell R, et al. Elderly patients benefit from second-line cytotoxic chemotherapy: a subset analysis of a randomized phase III trial of pemetrexed compared with docetaxel in patients with previously treated advanced non-small-cell lung cancer[J]. J Clin Oncol, 2006,24(27):4405-4411.
[10] Scagliotti GV, Parikh P, von Pawel J,et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer[J]. J Clin Oncol, 2008,26(21):3543-3551.
[11] Zukin M, Barrios CH, Rodrigues Pereira J, et al.Randomized phase III trial of single-agent pemetrexed versus carboplatin and pemetrexed in patients with advanced non-small-cell lung cancer and Eastern Cooperative Oncology Group performance status of 2[J]. J Clin Oncol,2013,31(23):2849-2853.
[12] Scagliotti G, Brodowicz T, Shepherd FA, et al. Treatment-by-histology interaction analyses in three phase III trials show superiority of pemetrexed in nonsquamous non-small cell lung cancer[J]. J Thorac Oncol, 2011,6(1):64-70.
[13] Gridelli C, Brodowicz T, Langer CJ, et al.Pemetrexed therapy in elderly patients with good performance status: analysis of two phase III trials of patients with nonsquamous non-small-cell lung cancer[J]. Clin Lung Cancer, 2012 ,13(5):340-346.
[14] 黄岩,刘云鹏,周建英,等.培美曲塞联合顺铂对比吉西他滨联合顺铂一线治疗晚期非鳞非小细胞肺癌的随机、对照、多中心临床研究[J].中国肺癌杂志,2012,15(10):576-582.

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