Treatment of stage IIIb/IV non-small cell lung cancer with Pemetrexed plus Oxaliplatin after failure of Erlotinib as second-line treatment

• Published in: Medical oncology (Northwood, London, England) London, England), 2013-06, Vol.30 (2), p.550, Article 550
• Main Authors: Shi, Sheng-Bin, Hu, Rong-Hang, Qi, Jie-Lin, Tang, Xiao-Yong, Tian, Jing, Li, Rui, Chang, Chun-Xiao
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - drug therapy; Adenocarcinoma - pathology; Adenocarcinoma of Lung; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cisplatin - administration & dosage; Cisplatin - adverse effects; Disease-Free Survival; Erlotinib Hydrochloride; Female; Glutamates - administration & dosage; Glutamates - adverse effects; Guanine - administration & dosage; Guanine - adverse effects; Guanine - analogs & derivatives; Hematology; Humans; Internal Medicine; Kaplan-Meier Estimate; Lung cancer; Lung Neoplasms - drug therapy; Lung Neoplasms - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Oncology; Organoplatinum Compounds - administration & dosage; Organoplatinum Compounds - adverse effects; Original Paper; Oxaliplatin; Pathology; Pemetrexed; Quinazolines - adverse effects; Quinazolines - therapeutic use; Treatment Outcome
• ISSN: 1357-0560; 1559-131X
• DOI: 10.1007/s12032-013-0550-7

To determine the efficacy and toxicity of Pemetrexed plus Oxaliplatin in patients suffering from stage IIIb or IV lung adenocarcinoma and being treated with Erlotinib as second-line treatment, a total of 45 patients were randomly divided into two groups. One group was treated with 500 mg/m 2 Pemetrexed plus 100 mg/m 2 Oxaliplatin, and the other was treated with 500 mg/m 2 Pemetrexed plus 75 mg/m 2 Cisplatin. All drugs were administered on day one of a 21-day cycle. In the Oxaliplatin group, 3 patients (13.6 %) experienced partial response (PR), 9 patients (41.0 %) showed stable disease (SD), and 10 patients (45.5 %) had progressive disease (PD). In the Cisplatin group, 2 patients (8.7 %) experienced PR, 7 patients (30.4 %) showed SD, and 14 patients (60.9 %) had PD. The PFS of the Oxaliplatin group and the Cisplatin group was 4.45 months (95 % CI 4.10–4.80) and 3.96 months (95 % CI 3.68–4.24) ( P  = 0.03), respectively. The median overall survival (OS) was 10.8 months (95 % CI 10.2–11.5) and 10.7 months (95 % CI 10.2–11.3) ( P  = 0.72), respectively. There was no statistically significant difference in the occurrence rate of grades 3 and 4 myelotoxicity between the two groups. However, there was a significant difference in the occurrence rate of grades 3 and 4 gastrointestinal reactions and peripheral neurotoxicity between the two groups ( P