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Pemetrexed And Carboplatin, An Active Option In First-line Treatment Of Elderly Patients With Advanced Non-small Cell Lung Cancer (NSCLC): A Phase II Trial.
R. Gervais, G. Robinet, C. Clément-Duchêne, F. Denis, C. El Kouri, P. Martin, N. Chouaki, N. Bourayou, J. Morère
Published 2013 · Medicine
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The synergistic activity of pemetrexed with platinum agents in non-small cell lung cancer (NSCLC) and the renal safety of carboplatin suggest a balanced benefit/risk profile for this combination in elderly patients. This multicenter, single-arm, phase II study included 62 patients (≥70 years) with chemonaïve advanced NSCLC, Eastern Cooperative Oncology Group performance status (ECOG PS) 0-1, and assigned to receive 6 cycles of 3-weekly pemetrexed 500 mg/m(2) and carboplatin AUC 5. The primary endpoint was objective tumor response rate (ORR). Sixty-two patients received at least one dose of chemotherapy. Median age was 76.4 years [70.2-86] and all patients had PS 0 (16.1%) or PS 1 (83.9%). Stage IIIb disease in 21% patients and stage IV in 79% patients. Non-squamous cell carcinoma in 66.1% patients (adenocarcinoma 51.6%, large cell carcinoma 8.1%, other 6.5%) and squamous cell carcinoma in 33.9% patients. ORR was 28.6% (95% confidence interval [CI], 16.58-43.26), all were partial responses. Stable disease rate was 42.9%. Grade 3/4 toxicities related to study drugs were: asthenia 16.1%, anorexia 4.8%, diarrhea 3.2%, neutropenia 51.6%, leucopenia 30.7%, thrombocytopenia 29%, anemia 19.4%. One related fatal septic shock occurred. In advanced NSCLC, pemetrexed use is restricted to non-squamous histology. The combination pemetrexed-carboplatin could be a valuable treatment option in elderly patients. Neutropenia was the most common toxicity. The ORR is within the range of data reported for pemetrexed-carboplatin in the general NSCLC population (24-31%).
This paper references
GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer
J. Ferlay (2013)
New Guidelines to Evaluate the Response to Treatment in Solid Tumors.
P. Therasse (2000)
Treatment of non-small cell lung cancer in the older patient.
A. Ganti (2012)
A phase II study of combination chemotherapy with docetaxel and carboplatin for elderly patients with advanced non - small
HJ Kim (2005)
EORTC Elderly Task Force and Lung Cancer Group and International Society for Geriatric Oncology (SIOG) experts' opinion for the treatment of non-small-cell lung cancer in an elderly population.
A. Pallis (2010)
Pemetrexed therapy in elderly patients with good performance status: analysis of two phase III trials of patients with nonsquamous non-small-cell lung cancer.
C. Gridelli (2012)
Single-agent versus combination chemotherapy in advanced non-small-cell lung cancer: the cancer and leukemia group B (study 9730).
R. Lilenbaum (2005)
Cisplatin- versus carboplatin-based chemotherapy in first-line treatment of advanced non-small-cell lung cancer: an individual patient data meta-analysis.
A. Ardizzoni (2007)
Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer.
G. Scagliotti (2008)
SEOM clinical guidelines for the treatment of non-small-cell lung cancer: an updated edition.
J. M. T. Pérez (2010)
Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial
É. Quoix (2011)
A phase II study of combination chemotherapy with docetaxel and carboplatin for elderly patients with advanced non-small cell lung cancer.
H. Kim (2010)
New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada.
P. Therasse (2000)
Meta - analysis of efficacy and safety of singleagent and doublet chemotherapy with or without platinum in advanced non - small cell lung cancer in the elderly , 2011 ASCO Annual Meeting
G DesGuetz (2009)
Maintenance pemetrexed plus best supportive care versus placebo plus best supportive care for non-small-cell lung cancer: a randomised, double-blind, phase 3 study
T. Ciuleanu (2009)
[American Society of Clinical Oncology Clinical Practice Guideline update on chemotherapy for stage IV non-small-cell lung cancer].
C. Azzoli (2010)
SEOM clinical guidelines for the treatment of non-small-cell lung cancer: an updated edition
J. M. Trigo Perez (2010)
Phase II study of pemetrexed in combination with carboplatin in the first‐line treatment of advanced nonsmall cell lung cancer
R. Zinner (2005)
2000 update of recommendations for the use of hematopoietic colony-stimulating factors: evidence-based, clinical practice guidelines. American Society of Clinical Oncology Growth Factors Expert Panel.
H. Ozer (2000)
Enrollment of Elderly Patients in Clinical Trials for Cancer Drug Registration: A 7-Year Experience by the US Food and Drug Administration
P. Loehrer (2006)
Phase III study by the Norwegian lung cancer study group: pemetrexed plus carboplatin compared with gemcitabine plus carboplatin as first-line chemotherapy in advanced non-small-cell lung cancer.
B. H. Grønberg (2009)
Chemotherapy and survival benefit in elderly patients with advanced non-small-cell lung cancer.
A. Davidoff (2010)
Pemetrexed combined with oxaliplatin or carboplatin as first-line treatment in advanced non-small cell lung cancer: a multicenter, randomized, phase II trial.
G. Scagliotti (2005)
SEER Cancer Statistics Review, 1975-2003
L. Ries (2006)
Meta-analysis of efficacy and safety of single-agent and doublet chemotherapy with or without platinum in advanced non-small cell lung cancer in the elderly.
G. des Guetz (2011)
This paper is referenced by
Interleukins as new prognostic genetic biomarkers in non-small cell lung cancer.
C. Pérez-Ramírez (2017)
Platinum doublets as first-line treatment for elderly patients with advanced non-small cell lung cancer.
P. Piacentini (2013)
Pemetrexed as indispensable drug for the treatment of non-squamous non-small cell lung cancer: the role in induction and maintenance therapy.
S. Minami (2014)
SEOM clinical guidelines for the treatment of non-small cell lung cancer (NSCLC) 2015
R. García-Campelo (2015)
Meta-analysis of pemetrexed plus carboplatin doublet safety profile in first-line non-squamous non-small cell lung cancer studies
I. Okamoto (2017)
The Lake Wobegon effect: are all cancer patients above average?
J. H. Wolf (2013)
Pemetrexed in non-small-cell lung cancer
M. Dediu (2014)
Platinum doublets as first-line treatment for elderly patients with advanced non-small cell lung cancer
Paolo Piacentini (2013)
SEOM clinical guidelines for the treatment of non-small cell lung cancer (NSCLC) 2013
C. Camps (2013)
Prospective, multicentre, single-arm phase II trial of pembrolizumab combined with carboplatin and pemetrexed in elderly patients with advanced, non-squamous non-small cell lung cancer
Y. Ozawa (2020)
Pharmacogenetics of platinum-based chemotherapy: impact of DNA repair and folate metabolism gene polymorphisms on prognosis of non-small cell lung cancer patients
C. Pérez-Ramírez (2018)
Pemetrexed for advanced stage nonsquamous non-small cell lung cancer: latest evidence about its extended use and outcomes
P. Tomasini (2016)
Carboplatin-containing regimens as front-line treatment for advanced non-small-cell lung cancer in two groups of elderly
Jacopo Giuliani (2014)
Determination methods for the anticancer drug dicycloplatin, a supramolecule assembled through hydrogen bonding.
Xuqing Yang (2015)
A phase II study of carboplatin and pemetrexed for elderly patients with advanced non-squamous non-small cell lung cancer
Hironari Nishizawa (2016)
Clinical factors associated with treatment toxicity of pemetrexed plus platinum in elderly patients with non-small cell lung cancer.
C. Chen (2020)
Pemetrexed for the treatment of non-small cell lung cancer
C. Genova (2013)
Pulmonary Adenocarcinoma Occurring 5 Years after Resection of a Primary Pancreatic Adenocarcinoma: A Relevant Differential Diagnosis
R. Falkenstern-Ge (2014)
Phase II trial of carboplatin and pemetrexed as first-line chemotherapy for non-squamous non-small cell lung cancer, and correlation between the efficacy/toxicity and genetic polymorphisms associated with pemetrexed metabolism: Hokkaido Lung Cancer Clinical Study Group Trial (HOT) 0902
Kenya Kanazawa (2014)
Medical Treatment in Elderly Patients with Non-Small Cell Lung Cancer
K. Bakirhan (2016)
NCCTG N0821 (Alliance): A Phase II First-Line Study of Pemetrexed, Carboplatin, and Bevacizumab in Elderly Patients with Advanced Nonsquamous Non–Small-Cell Lung Cancer With Good Performance Status
G. K. Dy (2014)
Carboplatin synergistically triggers the efficacy of photodynamic therapy via caspase 3-, 8-, and 12-dependent pathways in human anaplastic thyroid cancer cells
R. Biswas (2013)
The evolving role of pemetrexed disodium for the treatment of non-small cell lung cancer
G. Rossi (2018)
Prognostic factors in elderly patients with malignant pleural mesothelioma: results of a multicenter survey
G. Ceresoli (2014)
Final Efficacy and Safety Results of Pemetrexed Continuation Maintenance Therapy in the Elderly from the PARAMOUNT Phase III Study
C. Gridelli (2014)
A phase II study of biweekly paclitaxel and carboplatin in elderly patients with advanced non-small cell lung cancer
K. Soejima (2014)
Phase I study of carboplatin combined with pemetrexed for elderly patients with advanced non-squamous non-small cell lung cancer.
H. Takeoka (2014)