RESULTS OF TREATMENT OF PATIENTS WITH LOCALLY ADVANCED AND METASTATIC NON-SQUAMOUS CELL NON-SMALL-CELL LUNG CARCINOMA WITH PEMETREXED (BY OWN EXPERIENCE)
https://doi.org/10.21294/1814-4861-2016-15-1-26-30
Abstract
Lung cancer is one of the most common malignant tumors. As over 70 % of patients at diagnosis have locally advanced or generalized process, the majority of patients receive drug treatment only. We evaluated effectiveness and toxicity of pemetrexed (Alimta) in 24 patients with locally advanced and metastatic non-squamous cell non-small-cell lung carcinoma with the known EGFR mutation status. Pemetrexed 500 mg/m2 was administered as monotherapy (8 patients) or in combination with platinum-based drugs (15 patients). Three (12.5 %) patients showed complete regression, 7 (29.2 %) – partial regression, 10 (41.7 %) – stabilization, 4 (16.6 %) – progression. The median survival was 14.8 months. Non-hematological complications were registered, usually concerning the digestive system. Hematological complications included first-degree leukopenia – 27 (21.3 %), second- and third-degree thrombocytopenia – 1 case of each (0.8%). The complications did not require administration of drugs or were corrected medicamentally. We observed a high effectiveness of pemetrexed in patients with non-squamous NSCLC, as well as a low rate of complications and controlled toxicity.
About the Authors
L. Yu. Vladimirova
Rostov Research Institute of Oncology
Russian Federation
Russian Federation
MD, Professor, Head of the Department of Drug Therapy for Cancer,
63, 14 Line, 344037-Rostov-on-Don
A. E. Storozhakova
Rostov Research Institute of Oncology
Russian Federation
Russian Federation
MD, PhD, Senior Researcher, Department of Drug Therapy for Cancer,
63, 14 Line, 344037-Rostov-on-Don
S. N. Kabanov
Rostov Research Institute of Oncology
Russian Federation
Russian Federation
MD, PhD, Senior Researcher, Department of Drug Therapy for Cancer,
63, 14 Line, 344037-Rostov-on-Don
E. A. Kalabanova
Rostov Research Institute of Oncology
Russian Federation
Russian Federation
MD, PhD, Senior Researcher, Department of Drug Therapy for Cancer,
63, 14 Line, 344037-Rostov-on-Don
References
1. Vladimirova L.Yu., Kit O.I., Sholokhova E.A. The role of the histological and molecular analysis in choosing the method of treatment NSCLC late stages // Farmateka. 2012. № 8. P. 10–23. [in Rissian]
2. Davydov M.I., Aksel’ E.M. Statistics malignancies in Russia and the CIS countries in 2012. М., 2013. [in Rissian] 3. Kit O.I., Vladimirova L.Yu., Sholokhova E.A. Efficacy and safety ofpemetrexed maintenance therapy in advanced non-small-cell lung cancer: a review of phase III studies // Sovremennaja onkologija. 2013. Vol. 15 (1). P. 27–31. [in Rissian]
3. Azzoli C.G., Temin S., Aliff T., Baker S. Jr., Brahmer J., Johnson D.H., Laskin J.L., Masters G., Milton D., Nordquist L., Pao W., Pfister D.G., Piantadosi S., Schiller J.H., Smith R., Smith T.J., Strawn J.R., Trent D., Giaccone G. 2011 focused update of 2009 American Society of Clinical Oncology clinical practice guideline update on chemotherapy for stage IV non-small cell lung cancer // J. Clin. Oncol. 2011. Vol. 29 (28). P. 3825–3831. doi: 10.1200/JCO.2010.34.2774
4. D’Addario G., Früh M., Reck M., Baumann P., Klepetko W., Felip E. Metastatic non-small cell lung cancer. ESMO clinical practice guidelines for diagnosis, treatment and follow up // Ann. Oncol. 2010. Vol. 21 (Suppl. 5): v116–9. doi: 10.1093/annonc/mdq189.
5. Eisenhauer E.A., Therasse P., Bogaerts J., Schwartz L.H., Sargent D., Ford R., Dancey J., Arbuck S., Gwyther S., Mooney M., Rubinstein L., Shankar L., Dodd L., Kaplan R., Lacombe D., Verweij J. New response evaluation criteria in solid tumours: revised RECIST guideline (version 1.1) // Eur. J. Cancer. 2009. Vol. 45 (2). P. 228–247. doi: 10.1016/j.ejca.2008.10.026.
6. International Agensy for Research on Cancer (2013) GLOBOCAN 2012: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2012 (http:// globocan. iarc. fr / Default. aspx).
7. Giorgio C.G., Pappalardo A., Russo A., Giuffrida D., Santini D., Petralia G., Castorina S., Nunzio R., Failla G., Bordonaro R. A phase II study of carboplatin and paclitaxel as first line chemotherapy in elderly patients with advanced non-small cell lung cancer (NSCLC) // Lung Cancer. 2006. Vol. 51 (3). P. 357–362.
8. Gridelli C., Maione P., Rossi A., Ferrara M.L., Bareschino M.A., Schettino C., Sacco P.C., Ciardiello F. Potential treatment options after firstline chemotherapy for advanced NSCLC: maintenance treatment or early second-line? // Oncologist. 2009. Vol. 14 (2). P. 137–147. doi: 10.1634/theoncologist.2008-0152.
9. Grossi F., Aita M., Follador A., Defferrari C., Brianti A., Sinaccio G., Belvedere O. Sequential, alternating, and maintenance/consolidation chemotherapy in advanced non-small cell lung cancer: a review of the literature // Oncologist. 2007. Vol. 12 (4). P. 451–464.
10. Ozols R.F., Herbst R.S., Colson Y.L., Gralow J., Bonne J., Curran W.J., Eisenberg B.L., Ganz P.A., Kramer B.S., Kris M.G., Markman M., Mayer R.J., Raghavan D., Reaman G.H., Sawaya R., Schilsky R.L., Schuchter L.M., Sweetenham J.W., Vahdat L.T., Winn R.J. Clinical Cancer Advances 2006: Major Research Advances in Cancer Treatment, Prevention and Screening – A Report From the American Society of Clinical Oncology // JCO. 2007. Vol. 25 (1). P. 146–162.
11. Peterson P., Park K., Fossella F. et al. Is pemetrexed more effective in Adenocarcinoma and large cell lung cancer than in squamous cell carcinoma? A retrospective analysis of a phase III trial of pemetrexed vs. docetaxel in previously treated patients with advance non-small cell lung cancer (NSCLC) // J. Thorac. Oncol. 2007. Vol. 2 (4): S851 (abstract P2-238).
12. Rosell R., Carcereny E., Gervais R., Vergnenegre A., Massuti B., Felip E., Palmero R., Garcia-Gomez R., Pallares C., Sanchez J.M., Porta R., Cobo M., Garrido P., Longo F., Moran T., Insa A., De Marinis F., Corre R., Bover I., Illiano A., Dansin E., de Castro J., Milella M., Reguart N., Altavilla G., Jimenez U., Provencio M., Moreno M.A., Terrasa J., Muñoz-Langa J., Valdivia J., Isla D., Domine M., Molinier O., Mazieres J., Baize N., Garcia-Campelo R., Robinet G., Rodriguez-Abreu D., Lopez-Vivanco G., Gebbia V., Ferrera-Delgado L., Bombaron P., Bernabe R., Bearz A., Artal A., Cortesi E., Rolfo C., Sanchez-Ronco M., Drozdowskyj A., Queralt C., de Aguirre I., Ramirez J.L., Sanchez J.J., Molina M.A., Taron M., PazAres L. Erlotinib versus standard chemotherapy as first-line treatment for European patients with advanced EGFR mutation-positive non-small-cell lung cancer (EURTAC): a multicentre, open-label, randomised phase 3 trial // Lancet Oncol. 2012. Vol. 13. P. 239–246. doi: 10.1016/S1470-2045(11)70393-X.
13. Russell P.A., Wainer Z., Wright G.M., Daniels M., Conron M., Williams R.A. Does lung adenocarcinoma subtype predict patient survival?: A clinicopathologic study based on the new International Association for the Study of Lung Cancer/American Thoracic Society/European Respiratory Society international multidisciplinary lung adenocarcinoma classification // J. Thorac. Oncol. 2011. Vol. 6 (9).P. 1496–1504. doi: 10.1097/JTO.0b013e318221f701. 15. Scagliotti G., Kortsik C., Dark G.G., Price A., Manegold C., Rosell R.,
14. O’Brien M., Peterson P.M., Castellano D., Selvaggi G., Novello S., Blatter J., Kayitalire L., Crino L., Paz-Ares L. Pemetrexed combined with oxaliplatin or carboplatin as first-line treatment in advanced non-small-cell lung cancer: a multicenter, randomized, phase II trial // Clin. Cancer Res. 2005. Vol. 11. P. 690–696.
15. Scagliotti G.V., Parikh P., von Pawel J., Biesma B., Vansteenkiste J., Manegold C., Serwatowski P., Gatzemeier U., Digumarti R., Zukin M., Lee J.S., Mellemgaard A., Park K., Patil S., Rolski J., Goksel T., de Marinis F., Simms L., Sugarman K.P., Gandara D. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer // J. Clin. Oncol. 2008. Vol. 26 (21). P. 3543–3551. doi: 10.1200/JCO.2007.15.0375.
16. Scagliotti G., Hanna N., Fossella F., Sugarman K., Blatter J., Peterson P., Simms L., Shepherd F.A. The differential efficacy of pemetrexed according to NSCLC histology: a review of two Phase III studies // Oncologist. 2009. Vol. 14 (3). P. 253–263. doi: 10.1634/theoncologist.2008-0232.
17. Shepherd F.A., Dancey J., Arnold A., Neville A., Rusthoven J., Johnson R.D., Fisher B., Eisenhauer E. Phase II study of pemetrexed disodium, a multitargeted antifolate, and cisplatin in patients as first-line therapy in patients with advanced non-small cell lung cancer: a study of National Cancer Institute of Canada clinical trials group // Cancer. 2001. Vol. 92. P. 595–600.
18. Socinski M.A., Smit E.F., Lorigan P., Konduri K., Reck M., Szczesna A., Blakely J., Serwatowski P., Karaseva N.A., Ciuleanu T., Jassem J., Dediu M., Hong S., Visseren-Grul C., Hanauske A.R., Obasaju C.K., Guba S.C., Thatcher N. Phase III study of pemetrexed plus carboplatin compared with etoposide plus carboplatin in chemotherapy-naive patients with extensive-stage small cell lung cancer // J. Clin. Oncol.2009. Vol. 27 (28). P. 4787–4792. doi: 10.1200/JCO.2009.23.1548.
19. Stinchcombe T.E., Socinski M.A. Treatment paradigms for advanced stage non-small cell lung cancer in the era of multiple lines of therapy // J. Thorac. Oncol. 2009. Vo. 4 (2). P. 243–250. doi: 10.1097/JTO.0b013e31819516a6.
20. Zhang W., Guo N., Yu C., Wang H., Zhang Y., Xia H., Yu J., Lu J. Differencial expression of ERCC1 in the primary tumors and metastatic lymph nodes of patients with non-small cell lung cancer adenocarcinoma // Tumor Biol. 2012. Vol. 33. P. 2209–2216. doi: 10.1007/s13277-012-0482-4.
Review
For citations:
Vladimirova L.Yu., Storozhakova A.E., Kabanov S.N., Kalabanova E.A. RESULTS OF TREATMENT OF PATIENTS WITH LOCALLY ADVANCED AND METASTATIC NON-SQUAMOUS CELL NON-SMALL-CELL LUNG CARCINOMA WITH PEMETREXED (BY OWN EXPERIENCE). Siberian journal of oncology. 2016;15(1):26-30. (In Russ.) https://doi.org/10.21294/1814-4861-2016-15-1-26-30
Views:
3161
Email this article 
