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Pemetrexed Doublets Show Promise in Advanced Non-Small-Cell Lung Cancer: Presented at CFS

By Charlene Laino

NEW YORK, NY -- November 15, 2004 -- Pemetrexed in combination with either carboplatin or oxaliplatin is associated with a favorable benefit-to-risk ratio relative to other combination regimens for the treatment of advanced non-small-cell lung cancer (NSCLC), suggest results from a randomized phase 2 study.

Both regimens are associated with "an objective response on the order of 30%, comparable to any other platinum-based doublet," said Giorgio V. Scagliotti, professor of respiratory medicine, University of Toronto, Toronto, Ontario, Canada.

However, he said, grade 3/4 hematological and nonhematological toxicities are very low compared with the other doublets, he said during a presentation here on November 12th at the Chemotherapy FOUNDATIONS Symposium XXII: Innovative Cancer Therapy for Tomorrow.

Dr. Scagliotti and colleagues randomized 39 patients with advanced NSCLC topemetrexed plus carboplatin and another 41 NSCLC patients to pemetrexed plus oxaliplatin. Sixty percent of the patients had stage IV disease; the rest had stage IIIb cancer. The treatment arms were well balanced, except for an excess of males in the carboplatin arm, Dr. Scagliotti said.

"Toxicity was extremely low compared with our history with other doublets," he said. Grade 3/4 neutropenia was observed in 27% of patients in the carboplatin arm and 7% in the oxaliplatin arm. Grade 3 thrombocytopenia was observed in 18% and 2% of patients in the carboplatin and oxaliplatin arm, respectively. Grade 3 anemia developed in 8% of patients on carboplatin and 2% of those on oxaliplatin, he said.

Grade 3/4 fatigue was the most common nonhematological toxicity in the carboplatin arm, and affected 8% of patients, while vomiting was the most common in oxaliplatin-treated patients, at 7%.

Objective responses were observed in 31.6% of patients on the carboplatin doublet and in 26.8% of the oxaliplatin doublet; there was 1 complete response in the oxaliplatin arm, Dr. Scagliotti reported. Nearly half of patients in both arms had stable disease.

He said that the 1-year survival rates were 43.9% and 49.9%, respectively. Median overall survival was 10.5 months and median time to progression was about 5.5 months in both arms.

Further investigation in the phase 3 setting is warranted, Dr. Scagliotti said.

Eli Lilly helped fund the study, which is currently in press.


[Presentation title: Pemetrexed Combined With Oxaliplatin or Carboplatin in First-Line Treatment in Advanced Non-Small Cell Lung Cancer: a Multicenter, Randomized Phase 2 Trial. Abstract 65]

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