Pemetrexed versus vinorelbine treatment of advanced non‑squamous non-small cell lung cancer in elderly patients

Chen,Yongshun; Wen,Qinglian; Liu,Hao; Ao,Rui; Wu,Xiaoyuan; Guo,Leiming; Wang,Wen; He,Chunyu; Wang,Jianhua

doi:10.3892/mco.2013.77

May-June 2013 Volume 1 Issue 3

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

May-June 2013 Volume 1 Issue 3

Full Size Image

Article

Pemetrexed versus vinorelbine treatment of advanced non‑squamous non-small cell lung cancer in elderly patients

Authors:
- Yongshun Chen
- Qinglian Wen
- Hao Liu
- Rui Ao
- Xiaoyuan Wu
- Leiming Guo
- Wen Wang
- Chunyu He
- Jianhua Wang
View Affiliations / Copyright

Affiliations: Department of Clinical Oncology, Henan Tumor Hospital, Zhengzhou University Affiliated Tumor Hospital, Zhengzhou University, Zhengzhou, Henan 450008, P.R. China, Department of Clinical Oncology, Affiliated Hospital of Luzhou Medical College, Lizhou, Sichuan 646000, P.R. China, Department of Clinical Oncology, Sichuan People's Hospital, Chengdu, Sichuan 610072, P.R. China
Pages: 553-557
|
Published online on: February 18, 2013

https://doi.org/10.3892/mco.2013.77
Expand metrics +

Abstract

Pemetrexed, a multitargeted antifolate agent, has been shown to have clear activity in non‑squamous non‑small cell lung cancer (NSCLC). The aim of this retrospective studywas to evaluated the efficacy and toxicity of pemetrexed vs. vinorelbine in NSCLC elderly patients. Chemotherapy‑naive patients aged ≥70 years with stage IIIB/IV non‑squamous NSCLC and performance status ≤2 were eligible for inclusion in this study. Patients were selected to receive pemetrexed 500 mg/m2 (day 1) or vinorelbine 25 mg/m2 (days 1 and 8) every 21 days. In total, 62 patients were enrolled in the present study. Thirty‑six patients were treated with pemetrexed, and 26 with vinorelbine. The median number of cycles received was six in the pemetrexed group vs. four in the vinorelbine group. Pemetrexed demonstrated a significantly higher disease control rate (DCR) (80.5 vs. 65.3%; P=0.011), and an improvement in progression‑free survival (6.5 vs. 4.0 months; P=0.018) compared to vinorelbine. Neutropenia occurred in more patients in the vinorelbine group compared to the pemetrexed group, grade 3‑4 neutropenia was observed in 53.8 and 11.1% of patients in the two groups, respectively (P<0.001). Pemetrexed‑treated patients experienced lower frequencies of anemia, thrombocytopenia and non‑hematologic toxicities compared to vinorelbine‑treated patients. The toxicity profiles for the two treatment groups were mild and tolerable. In conclusion, pemetrexed improved DCR, progression‑free survival, and presented a lower incidence of treatment-related adverse events compared to vinorelbine, although overall survival was not significantly improved. As a result, pemetrexed monotherapy might be considered as a good option in the treatment of elderly patients with advanced non‑squamous NSCLC.

View Figures

View References

1.	Ettinger DS, Bepler G, Bueno R, et al: Non-small cell lung cancer. Clinical practice guidelines in oncology. J Natl Compr Canc Netw. 4:548–582. 2006.PubMed/NCBI
2.	Extermann M: Measuring comorbidity in older cancer patients. Eur J Cancer. 36:453–471. 2000. View Article : Google Scholar
3.	Gridelli C, Perrone F, Gallo C, et al: Chemotherapy for elderly patients with advanced non-small-cell lung cancer: the Multicenter Italian Lung Cancer in the Elderly Study (MILES) phase III randomized trial. J Natl Cancer Inst. 95:362–372. 2003. View Article : Google Scholar : PubMed/NCBI
4.	Hanauske AR, Eismann U, Oberschmidt O, et al: In vitro chemosensitivity of freshly explanted tumor cells to pemetrexed is correlated with target gene expression. Invest New Drugs. 25:417–423. 2007. View Article : Google Scholar : PubMed/NCBI
5.	Rollins KD and Lindley C: Pemetrexed: a multitargeted anti-folate. Clin Ther. 27:1343–1382. 2005. View Article : Google Scholar : PubMed/NCBI
6.	Therasse P, Arbuck SG, Eisenhauer EA, et al: 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. J Natl Cancer Inst. 92:205–216. 2000. View Article : Google Scholar
7.	National Cancer Institute: Cancer Therapy Evaluation Program: Investigator’s handbook: A Handbook for Clinical Investigators Conducting Therapeutic Clinical Trials Supported by CTEP, DCTD, NCI. http://ctep.cancer.gov/investigatorResources/investigators_handbook.htm. Accessed: January 24, 2012.
8.	Gridelli C: The ELVIS trial: a phase III study of single-agent vinorelbine as first-line treatment in elderly patients with advanced non-small cell lung cancer. Elderly Lung Cancer Vinorelbine Italian Study Oncologist. 6:4–7. 2001.PubMed/NCBI
9.	Nakamura Y, Sekine I, Furuse K and Saijo N: Retrospective comparison of toxicity and efficacy in phase II trials of 3-h infusions of paclitaxel for patients 70 years of age or older and patients under 70 years of age. Cancer Chemother Pharmacol. 46:114–118. 2000.PubMed/NCBI
10.	Kudoh S, Takeda K, Nakagawa K, et al: Phase III study of docetaxel compared with vinorelbine in elderly patients with advanced non-small-cell lung cancer: results of the West Japan Thoracic Oncology Group Trial (WJTOG 9904). J Clin Oncol. 24:3657–3663. 2006. View Article : Google Scholar : PubMed/NCBI
11.	Lang K, Marciniak MD, Faries D, et al: Trends and predictors of first-line chemotherapy use among elderly patients with advanced non-small cell lung cancer in the United States. Lung Cancer. 63:264–270. 2009. View Article : Google Scholar : PubMed/NCBI
12.	Cohen MH, Johnson JR, Wang YC, et al: FDA drug approval summary: pemetrexed for injection (Alimta) for the treatment of non-small cell lung cancer. Oncologist. 10:363–368. 2005. View Article : Google Scholar : PubMed/NCBI
13.	Effects of vinorelbine on quality of life and survival of elderly patients with advanced non-small-cell lung cancer. The Elderly Lung Cancer Vinorelbine Italian Study Group. J Natl Cancer Inst. 91:66–72. 1999. View Article : Google Scholar : PubMed/NCBI
14.	Frasci G, Lorusso V, Panza N, et al: Gemcitabine plus vinorelbine versus vinorelbine alone in elderly patients with advanced non-small-cell lung cancer. J Clin Oncol. 18:2529–2536. 2000.PubMed/NCBI
15.	Kubota K, Nishiwaki Y, Ohashi Y, et al: The Four-Arm Cooperative Study (FACS) for advanced non-small-cell lung cancer (NSCLC). J Clin Oncol (ASCO Annual Meeting Proceedings). 14S:abs. 7006. 2004.
16.	Mok TS, Wu YL, Thongprasert S, et al: Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 361:947–957. 2009. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Pemetrexed versus vinorelbine treatment of advanced non‑squamous non-small cell lung cancer in elderly patients

This article is mentioned in:

Abstract

Figure 1

Figure 2

Related Articles