PEMETREXED AND GEMCITABINE COMBINATION IN NSCLC

Lung Cancer. 2009 Jan 21. [Epub ahead of print]

Related Articles, Links

A phase II trial of pemetrexed and gemcitabine as first line therapy for poor performance status and/or elderly patients with stage IIIB/IV non-small cell lung cancer.

Blakely LJ, Schwartzberg L, Keaton M, Schnell F, Henry D, Epperson A, Walker MS.

Accelerated Community Oncology Research Network, 1770 Kirby Parkway, Suite 400, Memphis, TN 38138, United States.

Pemetrexed and gemcitabine are both active agents for the treatment of locally advanced or metastatic NSCLC. We tested a novel biweekly combination of pemetrexed and gemcitabine for tolerability and efficacy in 45 elderly and/or poor performance status patients (44% female, mean age of 72.4 years) with measurable stage IIIB/IV NSCLC. Patients received biweekly cycles of pemetrexed 500mg/m(2) IV over 10min followed by gemcitabine 1500mg/m(2) IV with vitamin B12 1000mug IM, and folic acid 1mg po daily beginning 7 days before and continuing throughout treatment (median of 4 cycles). Ten patients experienced grade 3/4 neutropenia, two had grade 3 febrile neutropenia, and two had grade 3 anemia. Patients with ECOG PS 2 appeared poorly suited for the regimen, with 61.5% completing 24 weeks) was 26.7%, and the median progression free survival was 3.5 months. However, ECOG 0-1 patients had longer PFS and tended to have a better response rate than ECOG 2 patients.