TITLE:
Prospective Analysis of Patients Treated with Chemotherapy in Metastatic Adenocarcinoma of Lung—Single Centre Experience
AUTHORS:
B. J. Srinivasa, L. P. Bhanu, Girish Badarke, Mohammad Nasiruddin, Sulav Sapkota, D. Tousif, Vishal Kulkarni, P. K. Kiran, Vinu Sarathy, G. S. Deepika, Amritanshu Ram, Raghavendra Rao, Shekar Patil, Radheshyam Naik
KEYWORDS:
Pemetrexed, Carboplatin, NSCLC, Cisplatin, EGFR
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.8 No.9,
September
20,
2017
ABSTRACT: Background: Lung cancer is the leading cause of cancer-related death worldwide with
an estimated 1.6 million new cases diagnosed each year. According to standard
guidelines in NSCLC, the effectiveness of combined chemotherapy
regimen comprises of pemetrexed and platinum, and very few reports are available in Indian population. This study shows the
experience with pemetrexed and platinum combination chemotherapy in metastatic
NSCLC in first line setting. Methods: Total 61 patients with following
inclusion criteria were recruited such as: 1) PS
of 1 and 2; 2) NSCLC of non-squamous histology; 3) locally
advanced or metastatic disease at diagnosis; 4)
should have received minimum 3 cycles of pemetrexed and platinum as first line
treatment and or continued for 6 cycles; 5)
EGFR/ALK mutated or EGFR/ALK unknown patients but must have received upfront
chemo. Primary endpoint of the present study is to assess Disease Control Rate
(DCR) (CR + PR + SD). Progression Free Survival, OS and Toxicity assessment
were secondary endpoints. Results: The mean number of average
chemotherapy cycles was found to be 4.38. The range of chemotherapy was 2 - 6
cycles. Disease control rate, defined as (CR + PR + SD),
was seen in 44 (72.1%) patients. (PR in 26 (42.62%), SD 18 (29.5%)),
Progressive disease (PD) was observed in 17 (27.9%) patients. Overall study showed that patients had PFS of 9.414
months (95% CI 6.709 - 12.120) and OS of 13.437 months (95% CI 10.721 -
16.153). Conclusion: Pemetrexed and platinum combination is effective
and well-tolerated chemotherapy regimen in
patients with metastatic adenocarcinoma lung cancer patients. Pemetrexed
and cisplatin may be more effective in particular. Early switch over
to TKIs is preferred immediately after obtaining molecular subtype
result.