Retreatment with pemetrexed chemotherapy in advanced non-small cell lung cancer patient

The aim of this study was to evaluate the feasibility and safety of retreatment the pemetrexed after the failure prior pemetrexed-based chemotherapy in non-small cell lung cancer (NSCLC) from our institute.

Patients with advanced NSCLC who were admitted to Zhejiang Cancer Hospital from Dec 2009 to Dec 2012 were retrospectively analyzed. All of the patients were given pemetrexed chemotherapy after the prior pemetrexed-based treatment. Survival analysis was evaluated by Kaplan-Meier method.

Twenty-five patients were included in current study. Initial pemetrexed-based therapy was given as first-line treatment in all patients. Nine patients retreated with pemetrexed as the fourth-line treatment, and sixteen as further-line. One patient (4%) achieved partial response (PR), 9 (36%) with stable disease (SD), and 15 (60%) had progressive disease (PD). The disease control rate (DCR) was 40% and the median progression-free survival (PFS) was 1.5 months (95% CI: 0.8-2.4 months). Patients with an initial PFS >6 months had a median PFS after retreatment of 2.2 months, while patients with an initial pemetrexed PFS ≤6 months had a median PFS after retreatment of 1.1 months (P=0.036). The toxicities associated with the 2nd pemetrexed were generally acceptable.

Retreatment of pemetrexed seems to be a potential therapeutic option for treatment of selected advanced NSCLC patients after failure of initial pemetrexed therapy, especially for the patients with a PFS more than 6 months in the initial pemetrexed treatment.