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Medline ® Abstract for Reference 28

of 'Systemic therapy for the initial management of advanced non-small cell lung cancer without a driver mutation'

A phase II trial of pemetrexed and gemcitabine as first line therapy for poor performance status and/or elderly patients with stage IIIB/IV non-small cell lung cancer.
Blakely LJ, Schwartzberg L, Keaton M, Schnell F, Henry D, Epperson A, Walker MS
Lung Cancer. 2009;66(1):97. Epub 2009 Jan 22.
Pemetrexed and gemcitabine are both active agents for the treatment of locally advanced or metastatic NSCLC. We tested a novel biweekly combination of pemetrexed and gemcitabine for tolerability and efficacy in 45 elderly and/or poor performance status patients (44% female, mean age of 72.4 years) with measurable stage IIIB/IV NSCLC. Patients received biweekly cycles of pemetrexed 500 mg/m(2) IV over 10 min followed by gemcitabine 1500 mg/m(2) IV with vitamin B12 1000 microg IM, and folic acid 1mg po daily beginning 7 days before and continuing throughout treatment (median of 4 cycles). Ten patients experienced grade 3/4 neutropenia, two had grade 3 febrile neutropenia, and two had grade 3 anemia. Patients with ECOG PS 2 appeared poorly suited for the regimen, with 61.5% completing<or = 2 cycles. The overall response rate was 17.8%, the clinical benefit rate (CR+PR+SD>24 weeks) was 26.7%, and the median progression free survival was 3.5 months. However, ECOG 0-1 patients had longer PFS and tended to have a better response rate than ECOG 2 patients.
Accelerated Community Oncology Research Network, Memphis, TN 38138, United States. jblakely@westclinic.com