Response of brain metastases from non-small cell lung cancer to first-line pemetrexed-based chemotherapy: A single-center experience.

Abstract

e18052 Background: Non Small Cell Lung Cancer (NSCLC) accounts for almost 80% of all lung malignancies, and 40% of these patients go on to develop brain metastases (BM). Furthermore, there are no grade 1 recommendations for the management of multiple BM. The most widely used treatment is whole-brain radiation therapy (WBRT). Current data on pemetrexed suggest that it is active against BM. This drug was recently made available in Italy for front-line treatment of non-squamous NSCLC. Methods: In 2010 we observed 8 patients with central nervous system metastases from non-squamous NSCLC at diagnosis. Patients were treated with first-line cisplatin 75 mg/m2 and pemetrexed 500 mg/m2 for a minimum of 3 cycles up to a maximum of 6 cycles in the absence of progressive disease (PD). Results: With regard to brain lesions, 5 patients had partial response (62.5%), 1 had complete response (12.5%), 1 showed stable disease (12.5%) and 1 had PD (12.5%). Only two patients were treated with concomitant WBRT, showing a partial response that continued during treatment and up to the final evaluation. Conclusions: Our data, although based on a relatively small case series, seem to confirm the activity of pemetrexed-based therapy against BM. If confirmed in a larger sample of patients, these results could modify the management of multiple BM by delaying radiotherapy in asymptomatic patients until PD occurs.