Adenocarcinoma has an excellent outcome with pemetrexed treatment in Korean patients: A prospective, multicenter trial

Received 24 December 2008; received in revised form 12 February 2009; accepted 15 February 2009. published online 19 March 2009.

Abstract

Objective This prospective multicenter study conducted by the Korean Cancer Study Group evaluated the efficacy and safety of pemetrexed in Korean patients with advanced non-small cell lung cancer (NSCLC) who had prior chemotherapy.

Patients and methods: Patients with stage IIIB or IV NSCLC in whom prior chemotherapy failed received pemetrexed 500mg/m2 every 3 weeks with folic acid and vitamin B12 supplementation until disease progression or the development of intolerable toxicity. Eighty-one patients were enrolled.

Results The overall response rate for 78 evaluable patients was 5.1% [95% confidence interval (CI) 1.4–12.6; partial response 4/78, no complete response]. The disease control rate including complete, partial response and stable disease was 46.2% (36/78, 95% CI 34.8–57.8). With a median 8.7 months follow-up, the median time to progression was 3.1 months (95% CI 1.17–5.03) and the median overall survival (OS) was 7.8 months (95% CI 5.19–10.35). The median OS for patients with adenocarcinoma histology was 18.7 months compared to 6.1 months for non-adenocarcinoma. In a multivariate analysis, Eastern Cooperative Oncology Group performance status 0–1 [hazards ratio (HR)=0.331, 95% CI 0.135–0.814] and adenocarcinoma (HR=0.504, 95% CI 0.283–0.899) were independent factors for prolongation of overall survival.Conclusions Pemetrexed monotherapy has promising efficacy in patients with advanced NSCLC as a second-line therapy with less hematologic and non-hematologic toxicity, especially in those with adenocarcinoma histology.

Keywords: Pemetrexed, Non-small cell lung cancer, Adenocarcinoma, Korean

a Department of Internal Medicine, Kangwon National University Hospital, Kangwon National University School of Medicine, Chuncheon 200-722, Republic of Korea

b Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Republic of Korea

c Division of Hematology/Oncology, Department of Internal Medicine, Seoul Veterans Hospital, Seoul 134-791,Republic of Korea

d Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon 442-723, Republic of Korea

e Research Institute and Hospital, National Cancer Center, Goyang 410-769, Republic of Korea

f Division of Hematology-Oncology, Department of Internal Medicine, Daegu Catholic University College of Medicine, Daegu 705-718, Republic of Korea

g Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746,Republic of Korea

h Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Bucheon 420-767, Republic of Korea

i Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 705-717, Republic of Korea

j Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym University School of Medicine, Seoul 134-701, Republic of Korea

k Department of Internal Medicine, Seoul Municipal Boramae Hospital, Seoul National University School of Medicine, Seoul 156-707, Republic of Korea

l Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul140-743, Republic of Korea

m Department of Internal Medicine, Eulji University School of Medicine, Daejon 302-799, Republic of Korea

Corresponding author at: Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea. Tel.: +82 2 3410 3459; fax: +82 2 3410 1754.

PII: S0169-5002(09)00106-8

doi:10.1016/j.lungcan.2009.02.008

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