Pemetrexed combined with cisplatin/carboplatin as first-line treatment for stage IIIb/IV adenocarcinoma of the lung

Objective To investigate the clinical efficacy and toxicity of pemetrexed combined with cisplatin/carboplatin as first-line treatment for patients with stageⅢb/Ⅳadenocarcinoma of the lung. Methods Fifty-two chemotherapy-naive patients with stage Mb or IV adenocarcinoma of the lung were enrolled in this study and all were confirmed by pathology or cytology.Patients received pemetrexed 500 mg /m~2 on the first day and cisplatin 25 mg /m~2 from the first day to the third days or carboplatin(AUC =5) on the first day.The therapy was repeated for 2 ~6 cmycles with 3 weeks as a cycle.Patients were evaluated as they complete every 2 cmycles.Results All 52 patients were evaluable for Objective response,there were 0 cmase of CR,19 cmases of PR,22 cmases of SD and 11 cmases of PD with an overall response rate(RR) of 36.5%,disease control rate(DCR) of 78.8%. The progression free survival(PFS) was 4.1 months.The adverse effects were mild and mainly were hematological toxicity and gastrointestinal response.There was no treatment-related death during the study.The RR of cisplatin and carboplatin groups were 37.1%and 35.3%(P 0.05);DCR were 80.0%and 76.5%(P0.05);PFS were 4.2 months and 4.1 months(P 0.05),respectively.The RR of elderly group(≥70y) and non-elderly group(70y) were 31.3%and 38.9%(P 0.05); DCR were 75.0%and 80.6%(P 0.05);PFS were 3.9 months and 4.3 months(P 0.05 ), respectively.Both the two groups presented mild adverse effects,and there were no statistical differences between them.Conclusion Pemetrexed combined with cisplatin/carboplatin shows good clinically efficacy and low side effects as the first-line treatment for patients with stageⅢb/Ⅳadenocarcinoma of the lung and should be considered as a standard therapeutic protocol.