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Japanese Journal of Clinical Oncology Advance Access originally published online on October 24, 2008
Japanese Journal of Clinical Oncology 2009 39(1):27-32; doi:10.1093/jjco/hyn118
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© The Author (2008). Published by Oxford University Press. All rights reserved

Efficacy and Toxicity of Pemetrexed as a Third-line Treatment for Non-small Cell Lung Cancer

Jong-Mu Sun1,2, Keun-Wook Lee1,2, Jee Hyun Kim1,2, Yu Jung Kim1,2, Ho Il Yoon1,2, Jae-Ho Lee1,2, Choon-Taek Lee1,2 and Jong Seok Lee1,2

1 Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam
2 Department of Internal Medicine, Seoul National University, College of Medicine, Seoul, Republic of Korea

For reprints and all correspondence: Jong Seok Lee, Department of Internal Medicine, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeongi-do, 463-707, Republic of Korea. E-mail: jslee{at}snubh.org

Received August 14, 2008; accepted September 24, 2008

Objective: Pemetrexed has been approved for second-line treatment in non-small cell lung cancer (NSCLC). However, the role of third-line pemetrexed therapy in NSCLC has not yet been generally accepted. We attempted to validate third-line pemetrexed therapy and evaluate predictive factors for pemetrexed therapy for NSCLC.

Methods: Medical records of NSCLC patients who received pemetrexed therapy that progressed after systemic therapy were reviewed retrospectively. We stratified patients according to clinicopathologic characteristics to find predictive factors for pemetrexed therapy.

Results: A total of 100 patients were eligible for analysis, and overall progression-free survival (PFS) was 3.03 months. The objective response rate was 12%, and the toxicity profile was favorable. Pemetrexed was used as a second-line treatment in 30% of patients, and as third- or further-line treatment in 70%. Comparing the efficacy of pemetrexed in these two settings (second-line versus third- or further-line), there was no significant difference in terms of PFS (3.07 versus 2.83 months, P = 0.86). When we evaluated predictive factors by multivariate analysis, performance status significantly influenced PFS.

Conclusions: Pemetrexed is a suitable third-line treatment option with good efficacy and tolerable toxicity profile for NSCLC.

Key Words: non-small cell lung cancer • second-line • third-line • pemetrexed


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