Phase II study of High-Dose Pemetrexed plus cisplatin as first line chemotherapy in the theatment of patients with brain metastases from lung adenocarcinoma

• Published in: World neurosurgery 2015
• Main Authors: He, Qiaowei, Wang, Yong, Zou, Peng, Wang, Yunbo, Xiu, Chunming, Zhang, Hongtao, Chi, Nan, Zou, Haining, Xu, Jun, Zhou, Shizhen, Tao, Rongjie
• Format: Article
• Language: English
• Subjects: Neurosurgery
• ISSN: 1878-8750
• DOI: 10.1016/j.wneu.2016.03.098

Abstract Background Brain metastases (BM) occur in up to 40% of non-small-cell-lung cancer (NSCLC) patients. When surgery or radio-surgery are not possible, whole brain radiotherapy (WBRT) is the standard treatment, with a cerebral response rate of approximately 30%. Pemetrexed-based chemotherapy presented about 40% response rate on brain lesions of NSCLC with brain metastases. Methods This trial assessed the efficacy and safety of high-dose pemetrexed plus cisplatin in NSCLC with brain metastases after WBRT. Thirty two patients with KPS≥70 were enrolled. Patients of NSCLC with brain metastases were eligible for WBRT which was administered at 30Gy/10f. Thereafter, high-dose pemetrexed plus cisplatin was given up to six cycles. Primary end point was objective response rate (RR) and progression free survival (PFS) on BM. Secondary end points included extracerebral and overall RR, safety profile and survival. Results The objective cerebral RR (complete and partial response) was 68.8 % (22 of 32 patients). Extracerebral and globe RR was 37.5% and 31.3 %, respectively. The median progression free survival of BM was 13.6 months, and median overall survival was19.1 months. Conclusions This modality of treatment appears to a better efficacy and a good safety of BM, as well as extracerebral. Further clinical studies are warranted.