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Published on: February 12, 2017
Second-line chemotherapy for non-small cell lung cancer
F De Marinis1, S De Santis, L De Petris
15th Pneumo-Oncology Unit, Department of Oncology, San Camillo-Forlanini Hospitals, Rome, Italy. demarinis.filippo@virgilio.it
Summary
Pemetrexed is an effective second-line chemotherapy for non-small cell lung cancer, showing comparable efficacy to docetaxel with improved tolerability. Vitamin supplementation enhances its safety profile.
Area of Science:
- Oncology
- Medical Chemistry
Background:
- Second-line chemotherapy for non-small cell lung cancer (NSCLC) is typically reserved for patients with good performance status (ECOG PS 0-1) and selected PS 2 patients.
- Approved agents in the US include docetaxel, gefitinib, erlotinib, and pemetrexed; Europe approves docetaxel and pemetrexed for this indication.
Purpose of the Study:
- To review the role of pemetrexed in second-line NSCLC treatment.
- To discuss its development, efficacy, toxicity, and cost-effectiveness compared to docetaxel.
Main Methods:
- Review of controlled phase II trials and a large phase III registration trial comparing pemetrexed to docetaxel.
- Analysis of patient data regarding toxicity, quality of life, elderly patient outcomes, and cost.
Main Results:
- Pemetrexed demonstrates efficacy comparable to docetaxel in second-line NSCLC.
- Vitamin supplementation strategies have been developed to mitigate pemetrexed-related toxicity.
- Further analyses explore pemetrexed's role in specific populations and its economic impact.
Conclusions:
- Pemetrexed is a viable and well-tolerated option for second-line NSCLC treatment.
- Ongoing trials aim to optimize pemetrexed dosing for enhanced activity while maintaining safety.
