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Maintenance Therapy With Pemetrexed Improves Survival in Patients With NSCLC NEW YORK -- September 24, 2009 -- Giving pemetrexed maintenance therapy to patients with non-small-cell lung cancer (NSCLC) who have not had disease progression after initial platinum-based chemotherapy, improves both overall and progression-free survival (PFS), according to a study published online first and in an upcoming edition of The Lancet. Chandra Belani, MD, Penn State Hershey Cancer Institute, Hershey, Pennsylvania, and colleagues, assessed pemetrexed as maintenance therapy as part of first-line treatment in patients who had received 4 cycles of platinum-based chemotherapy and not had disease progression. Researchers randomised 663 patients with advanced NSCLC in a 2:1 ratio to receive pemetrexed 500 mg/m² (day 1) plus best supportive care (n = 441) or placebo plus best supportive care (n = 222) in 21-day cycles until disease progression. The primary endpoint was PFS and the secondary endpoint was overall survival (OS). The researchers found that pemetrexed significantly improved PFS (4.3 vs 2.6 months); and overall survival (13.4 vs 10.6 months) compared with placebo. Treatment discontinuations due to drug-related toxic effects were higher in the pemetrexed group than in the placebo group (21 patients vs 3 patients). Drug-related grade 3 or higher toxic effects were higher with pemetrexed than with placebo (16% vs 4%; P < .0001), specifically fatigue (5% vs 1%) and neutropenia (3% vs 0). No pemetrexed-related deaths occurred. A smaller proportion patients in the pemetrexed group than in the placebo group received systemic post-discontinuation therapy (227 patients vs 149 patients). “Pemetrexed maintenance therapy is well tolerated and offers significantly improved progression-free and overall survival compared with placebo, making it a new treatment option for patients with advanced non-squamous non-small-cell lung cancer who do not progress after initial induction therapy,” the authors concluded. SOURCE: The Lancet E-mail this page to a friend or colleague! To print, use this version