Related Experiment Videos
Pemetrexed in advanced colorectal cancer
Christophe Louvet1, Aimery de Gramont
1Hôpital St-Antoine, Service de Medecine Int-Onc, Paris, France. christophe.louvet@sat.ap-hop-paris.fr
Oncology (Williston Park, N.Y.)
|January 20, 2005
Summary
Pemetrexed (Alimta) combined with oxaliplatin shows promise in advanced colorectal cancer, with vitamin supplementation improving tolerability and reducing side effects. Further trials are exploring optimal dosing and combinations for improved patient outcomes.
Area of Science:
- Oncology
- Medical Oncology
- Gastrointestinal Oncology
Background:
- Pemetrexed (Alimta) demonstrates single-agent activity in advanced colorectal cancer.
- Early trials predated folic acid and vitamin B12 supplementation, which significantly reduced pemetrexed's hematologic toxicities.
- Vitamin supplementation necessitates reevaluation of optimal pemetrexed dosing in combination therapies.
Purpose of the Study:
- To evaluate the efficacy and safety of pemetrexed in combination with oxaliplatin for advanced colorectal cancer.
- To assess the impact of folic acid and vitamin B12 supplementation on pemetrexed-based regimens.
- To inform ongoing and future clinical trials investigating pemetrexed combinations.
Main Methods:
- A National Surgical Adjuvant Breast and Bowel Project phase II trial administered pemetrexed (500 mg/m2) plus oxaliplatin (120 mg/m2) every 21 days with vitamin supplementation.
- Objective response rates, progression-free survival, duration of response, and overall survival were assessed.
- Toxicity, particularly Grade 3/4 neutropenia, was monitored.
Main Results:
- The pemetrexed/oxaliplatin combination achieved an objective response rate of 23%, with 50% stable disease.
- Median progression-free survival was 5.3 months, and median overall survival was approximately 11.05 months.
- Grade 3/4 neutropenia occurred in only 17% of patients, indicating good tolerability.
Conclusions:
- Pemetrexed in combination with oxaliplatin, with vitamin supplementation, is a well-tolerated and effective first-line treatment for advanced colorectal cancer.
- Ongoing phase I/II and planned phase III trials will further optimize pemetrexed-based regimens and compare them with standard treatments like FOLFOX4.