Document Detail


Second-line chemotherapy for non-small-cell lung cancer: recent data with pemetrexed.
MedLine Citation:
PMID:  15117429     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Platinum-based chemotherapy offers a modest survival advantage over best supportive care (BSC) in chemotherapy-naive patients with a good performance status and advanced/metastatic non-small-cell lung cancer (NSCLC). Based on 2 landmark studies that reported improved survival times and quality of life when comparing docetaxel with ifosfamide, vinorelbine, or BSC alone, docetaxel at 75 mg/m(2) given once every 3 weeks has been the standard of care as second-line chemotherapy since 2000. Docetaxel given at this dose and schedule resulted in significant hematologic toxicity, with many patients at risk for neutropenic fever. Pemetrexed is a novel multitargeted antifolate agent with single-agent activity in first- and second-line treatment of NSCLC. A phase III study in 571 patients comparing pemetrexed with docetaxel demonstrated clinically equivalent therapeutic outcomes in second-line treatment of patients with recurrent NSCLC; however, patients on the pemetrexed arm had a more favorable hematologic toxicity profile, with fewer episodes of neutropenia, neutropenic fever, and infections and less use of granulocyte colony-stimulating factor support. Based on these data, pemetrexed is a reasonable second-line chemotherapy option for patients with recurrent, advanced NSCLC.
Authors:
Nasser H Hanna
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Clinical lung cancer     Volume:  5 Suppl 2     ISSN:  1525-7304     ISO Abbreviation:  Clin Lung Cancer     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-30     Completed Date:  2004-09-02     Revised Date:  2008-12-12    
Medline Journal Info:
Nlm Unique ID:  100893225     Medline TA:  Clin Lung Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S75-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, Indiana University, Indianapolis 46202, USA. nhanna@iupui.edu
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MeSH Terms
Descriptor/Qualifier:
Antineoplastic Agents / therapeutic use*
Carcinoma, Non-Small-Cell Lung / drug therapy*
Clinical Trials as Topic
Dose-Response Relationship, Drug
Drug Administration Schedule
Glutamates / therapeutic use*
Guanine / analogs & derivatives*,  therapeutic use*
Humans
Lung Neoplasms / drug therapy*
Neoplasm Recurrence, Local / drug therapy*
Taxoids / therapeutic use
Chemical
Reg. No./Substance:
0/Antineoplastic Agents; 0/Glutamates; 0/Taxoids; 114977-28-5/docetaxel; 137281-23-3/pemetrexed; 73-40-5/Guanine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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