Clinical observation of pemetrexed monotherapy or in combination with platinum as second-line treatment to advanced non-squamous non-small cell lung cancer

Objective To evaluate the efficacy and adverse effects of pemetrexed monotherapy or pemetrexed in combination with platinum for the treatment of advanced non-squamous non-small cell lung cancer(NSCLC). Methods A total of 309 patients with advanced non-squamous NSCLC confirmed with pathology or cytology were devided single-agent group(patients received pemetrexed 500 mg/m2 on day 1) and combination group(patients received pemetrexed 500 mg/m2 on day 1 and cisplatin 75 mg/m2 or carboplatin AUC=5 on day 1 by intravenous infusion, administrated every 3 weeks for 2 to 6 cycles). Results Among 309 cases, complete remission(CR) was 2 cases, partial remission(PR) was 56 cases, stable disease(SD) was 99 cases, and disease progression(PD) was 152 cases. Objective response rate(ORR) of singe-agent group and combination group were 15.3% and 20.9%(P=0.274) respectively. Disease control rate(DCR) of singe-agent group and combination group were 38.1% and 57.6%(P=0.001). 1-year survival rate of singe-agent group and combination group were 42.4% and 43.5%(P=0.853). The median progression-free survival(PFS) of singe-agent agent group and combination group were 3.7 and 5.0 months(P=0.000). Overall survival(OS) of singe-agent group and combination group were 11.4 and 12.0 months(P=0.091). The main adverse reactions of two groups were grade 1/2 neutropenia, anemia,fatigue and gastrointestinal reaction. Hematological toxicity, gastrointestinal reaction and fatigue of single-agent group were signifi cantly lower than those of combination group(P 0.05).Conclusion Pemetrexed monotherapy has curative effect and safe for advanced NSCLC patients.