Efficacy and safety of pemetrexed and cisplatin chemotherapy as first line in advanced stage of lung adenocarcinoma.

Abstract

Background: Pemetrexed is a newer antifolate drug that has multiple intracellular targets. Clinical trials of Pemetrexed in advanced nonsmall cell lung carcinoma (NSCLC) setting have demonstrated beneficial outcomes. This study evaluated the efficacy and safety of Pemetrexed and Cisplatin combination as first line in advanced stage NSCLC adenocarcinoma patients. Methods: This was a prospective study conducted on previously untreated 50 patients with NSCLC (adenocarcinoma) of stage III B and IV disease. Patients received Pemetrexed 500 mg/m2 and Cisplatin 75 mg/m2 on day 1 of every 21-day cycle for a total of 6 cycles. Tumor response was calculated after 3 cycles and 6 cycles as per RECIST criteria version 1.1. Toxicity and adverse events (AEs) were assessed as per Common Terminology Criteria for Adverse Events (CTCAE) version 3. Results: The tumor response rate after 6 cycles of chemotherapy was as follows: 12% (6) patients had complete response, 48% (24) had a partial response, and 22% (11) stable disease. The overall response rate was 60% and the clinical benefit rate was 82%. Out of total patients, hematological toxicity in the form grade 3/4 granulocytopenia was seen in 20 (40%) patients, followed grade 3/4 leukopenia 12 (24%), grade 3/4 anaemia in 5 (10%) and grade 3/4 thrombocytopenia in 5(10%). Whereas nonhematological toxicity was comparatively less in the form of grade 3 vomiting in 2 (4%) patients. Over all this combination was well tolerated. Conclusion: Pemetrexed and Cisplatin chemotherapy combination was found to be efficacious and was well tolerated in advanced NSCLC adenocarcinoma patients.