Efficacy of Pemetrexed or Gemcitabine Combined with Cis-platinum on Patients with Advanced Non-small-cell Lung Carcinoma and Its Effect on Serum miR-365

Abstract

Objective: To determine the efficacy of pemetrexed or gemcitabine combined with cis-platinum on patients with advanced non-small-cell lung carcinoma (NSCLC) and its effect on serum miR-365. Methods: A total of 183 patients with NSCLC were enrolled and assigned to a pemetrexed + cis-platinum group (PC group) and a gemcitabine + cis-platinum group (GC group) according to their chemotherapy regimens. The two groups were compared in general data, therapeutic effect, drug-associated toxicity, life quality, 3-year survival outcome, and serum miR-365. Results: There was no significant difference between the two groups in remission rate and disease control rate, and the PC group experienced notably less hematological events including thrombocytopenia than the GC group, but had no significant difference with the latter in nausea, vomiting, constipation, abnormal liver function, esophageal injury and peripheral neurotoxicity. Additionally, there was no significant difference between the two groups in the improvement rate of Karnofsky performance scale, increased appetite, body mass gain, 3-year overall survival and progression-free survival, while the PC group showed better grade 3-4 toxicity-free survival outcome than the GC group. Moreover, serum miR-365 was up-regulated in cases with NSCLC, and decreased in both groups after treatment, while it was lower in the PC group than in the GC group over the same period after treatment. Conclusion: Both pemetrexed or gemcitabine combined with cis-platinum can strongly mitigate advanced NSCLC and suppress serum miR-365, but the former is safer.