Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
권호 표지
DOI QR코드

DOI QR Code

Study of Pemetrexed-based Chemotherapy for Patients with Locally Advanced or Metastatic Cancers

  • Qian, Ting (Department of Chemotherapy, the Affiliated Jiangsu Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research) ;
  • Huang, Xin-En (Department of Chemotherapy, the Affiliated Jiangsu Cancer Hospital of Nanjing Medical University & Jiangsu Institute of Cancer Research)
  • Published : 2015.06.26
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was conducted to observe the efficacy and safety of pemetrexed based chemotherapy in treating patients with locally advanced or metastatic cancers as first-line, second-line or third-line therapy. Materials and Methods: From May 2011 to January 2015, we recruited 29 patients with advanced breast cancer, 19 patients with advanced ovary cancer, 17 patients with advanced esophageal cancer,5 patients with advanced gallbladder cancer,5 patients with advanced cervical cancer and 1 patient with advanced tongue cancer in Jiangsu Cancer Hospital and Research Institute.All of them were pathologically confirmed and treated with pemetrexed based chemotherapy. After two cycles of treatment,efficacy and safety can be evaluated. Results: For pemetrexed based regimens,including 76 patients with 6 kinds of advanced cancer were considered eligible for inclusion. Complete remission represents CR, partial remission represents PR, stable disease represents SD, progressive disease represents PD. Among 29 patients with advanced breast cancer, 4 patients chose pemetrexed based regimens as second-line treatment,1 of them was PR,the other 3 got SD. The last 25 patients made use of this chemotherapy as third-line treatment, except one patient could not be assessed, 2 of them got PR,6 of them got SD,the remaining 16 of them finally were PD.19 patients with advanced ovary cancer,5 patients used this regimens as second-line treatment, 3 of them got PD,the remaining patients got SD, respectively. The last 14 patients made use of pemetrexed based regimens as third-line treatment,. RR (CR+PR) was 28.5%. Among 17 patients with advanced esophageal cancer, 2 patients made use of pemetrexed based regimens as first-line treatment,both of them got PR.4 of them used this chemotherapy as second-line regimen, except 2 patients could not be assessed,the remaining 2 was PD at last. The last 11 patients was third-line users, RR (CR+PR) was 18.2%. Among 5 patients with advanced gallbladder cancer, pemetrexed based regimens was used in 1 patient as first-line treatment and 1 patient as second-line treatment. The curative effect was SD and PD, respectively. 3 patients accepted pemetrexed based regimens as third-line treatment, 2 of them got PD as results and another was SD. Among 5 patients with advanced cervical cancer, just 1 patient adopted pemetrexed based regimens as first-line treatment, whose curative effect was PR.2 patients chose this chemotherapy regimens as second-line treatment. Both of them got PD as their consequence. The last 2 patients made use of the regimens as third-line treatment, the effect of them was PD and SD, respectively. The one who with advanced tongue cancer, pemetrexed based regimens was used as second-line treatment, and the consequence was PD. About 71.1% patients experienced bone marrow suppression. Among them, 5 patients reached 4 grade. Other toxicity of pemetrexed were neurotoxicity, fatigue, diarrhea, dysphagia and vomiting. No treatment related death occurred with pemetrexed-based treatment. Conclusions: Pemetrexed based chemotherapy has considerable effect in patients with advanced cancers such as breast cancer,esophageal cancer and ovary cancer. More randomly clinical trials are needed to verify the results.

Keywords

References

  1. Abahssain H1, Afchain P, Melas N, et al (2010). Chemotherapy in gallbladder carcinoma. Presse Med, 39, 1238-45. https://doi.org/10.1016/j.lpm.2010.09.002
  2. Agarwal SK, Munjal M, Koul R, et al (2014). Prospective evaluation of the quality of life of oral tongue cancer patients before and after the treatment. Ann Palliat Med, 3, 238-43.
  3. Alberts SR1, Sande JR, Foster NR, et al (2007). Pemetrexed and gemcitabine for biliary tract and gallbladder carcinomas: a North Central Cancer Treatment Group (NCCTG) phase I and II Trial, N9943. J Gastrointest Cancer, 38, 87-94. https://doi.org/10.1007/s12029-008-9037-8
  4. Bajetta E, Celio L, Buzzoni R et al (2003). Phase II study of pemetrexed disodium (Alimta) administered with oral folic acid in patients with advanced gastric cancer. Ann Oncol, 14, 1543-8. https://doi.org/10.1093/annonc/mdg406
  5. Cripps C, Burnell M, Jolivet J, et al (1999). Phase II study of first-line LY231514 (multi-targeted antifolate) in patients with locally advanced or metastatic colorectal cancer: an NCIC Clinical Trials Group study. Ann Oncol, 10, 1175-9. https://doi.org/10.1023/A:1008372529239
  6. De Gramont A, Figer A, Seymour M, et al (2000). Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment in advanced colorectal cancer. J Clin Oncol, 18, 2938-47. https://doi.org/10.1200/JCO.2000.18.16.2938
  7. Essam Eldin N1, Elnahas HM, Mahdy MA, et al (2015). Liposomal pemetrexed: formulation, characterization and in vitro cytotoxicity studies for effective management of malignant pleural mesothelioma. Biol Pharm Bull, 38, 461-9. https://doi.org/10.1248/bpb.b14-00769
  8. Garin A, Manikhas A, Biakhov M, et al (2008). A phase II study of pemetrexed and carboplatin in patients with locally advanced or metastatic breast cancer. Breast Cancer Res Treat, 110, 309-15. https://doi.org/10.1007/s10549-007-9722-5
  9. Giovannetti E, Mey V, Danesi R, et al (2004). Synergistic cytotoxicity and pharmacogenetics of gemcitabine andpemetrexed combination in pancreatic cancer cell lines. Clin Cancer Res, 10, 2936-43. https://doi.org/10.1158/1078-0432.CCR-03-0520
  10. Hanauske AR, Chen V, Paoletti P, et al (2001). Pemetrexed disodium: a novel antifolate clinically active against multiple solid tumors. The Oncologist, 6, 363-373. https://doi.org/10.1634/theoncologist.6-4-363
  11. Hellner K, Munger K (2011). Human papillomaviruses as therapeutic targets in human cancer. J Clin Oncol, 29, 1785-94. https://doi.org/10.1200/JCO.2010.28.2186
  12. Hochster HS (2004). The role of pemetrexed in the treatment of gastrointestinal malignancy. Clin Colorectal Cancer, 4, 190-5. https://doi.org/10.3816/CCC.2004.n.019
  13. Huang XE, Hirose K, Wakai K, et al (2004). Comparison of lifestyle risk factors by family history for gastric, breast, lung and colorectal cancer. Asian Pac J Cancer Prev, 5, 419-27.
  14. Jatoi A, Soori G, Foster NR, et al (2010). Phase II study of preoperative pemetrexed, carboplatin, and radiation followed by surgery for locally advanced esophageal cancer and gastroesophageal junction tumors. J Thorac Oncol, 5, 1994-8. https://doi.org/10.1097/JTO.0b013e3181fb5c3e
  15. Jemal A, Bray F, Center MM, et al (2011). Global cancer statistics. CA Cancer J Clin, 61, 69-90. https://doi.org/10.3322/caac.20107
  16. John W, Picus J, Blanke CD, et al (2000). Activity of multitargeted antifolate (pemetrexed disodium, LY231514) in patients with advanced colorectal carcinoma: results from a phase II study. Cancer, 88, 1807-13. https://doi.org/10.1002/(SICI)1097-0142(20000415)88:8<1807::AID-CNCR8>3.0.CO;2-L
  17. Katipamula R, Jatoi A, Foster NR, et al (2008). Pemetrexed, carboplatin, and concomitant radiation followed by surgery for locally advanced esophageal cancer: results of a planned interim toxicity analysis of north central cancer treatment group study N044E. Clin Med Oncol, 2, 223-5.
  18. Leemans CR, Braakhuis BJ, Brakenhoff RH (2010). The molecular biology of head and neck cancer. Nat Rev Cancer, 11, 9-22.
  19. Li BS, Gong HY, Huang W, et al (2011). Phase I study of concurrent selective lymph node late course accelerated hyper-fractionated radiotherapy and pemetrexed, cisplatin for locally advanced esophageal squamous cell carcinoma. Dis Esophagus, b, 251-7.
  20. Liu J, Huang XE, Feng JF, (2014). Further study on pemetrexed based chemotherapy in treating patients with advanced gastric cancer (AGC). Asian Pac J Cancer Prev, 15, 6587-90. https://doi.org/10.7314/APJCP.2014.15.16.6587
  21. Lorusso D, Ferrandina G, Pignata S, et al (2010). Evaluation of pemetrexed (Alimta, LY231514) as second-line chemotherapy in persistent or recurrentcarcinoma of the cervix: the CERVIX 1 study of the MITO (Multicentre Italian Trials in Ovarian Cancer and Gynecologic Malignancies) Group. Ann Oncol, 21, 61-6. https://doi.org/10.1093/annonc/mdp266
  22. Louvet C, de Gramont A (2004). Pemetrexed in advanced colorectal cancer. Oncology (Williston Park), 18, 56-62.
  23. Matulonis UA, Horowitz NS, Campos SM, et al (2008). Phase II study of carboplatin and pemetrexed for the treatment of platinum-sensitive recurrent ovarian cancer. J Clinical Oncology, 26, 5761-6. https://doi.org/10.1200/JCO.2008.17.0282
  24. Miyazaki T, Sohda M, Tanaka N, et al (2013). Phase I dose-escalation study of docetaxel, nedaplatin, and 5-fluorouracil combination chemotherapy in patients with advanced esophageal cancer. Cancer Chemother Pharmacol, 71, 853-7. https://doi.org/10.1007/s00280-013-2076-2
  25. Parkin DM, Bray F, Ferlay J, et al (2004). Global cancer statistics, 2002. CA Cancer J Clin, 55, 74-108.
  26. Parkin DM, Bray F, Ferlay J, et al (2005). Global cancer statistics, 2002. CA Cancer J Clin, 55, 74-108. https://doi.org/10.3322/canjclin.55.2.74
  27. Price KA, Cohen EE, (2012). Current treatment options for metastatic head and neck cancer. Curr Treat Options Oncol, 13, 35-46. https://doi.org/10.1007/s11864-011-0176-y
  28. Robert NJ, Conkling PR, O'Rourke MA, et al (2011). Results of a phase II study of pemetrexed as first-line chemotherapy in patients with advanced or metastatic breast cancer. Breast Cancer Res Treat, 126, 101-8. https://doi.org/10.1007/s10549-010-1286-0
  29. Robert NJ, Conkling PR, O'Rourke MA, et al (2011). Results of a phase II study of pemetrexed as first-line chemotherapy in patients with advanced or metastatic breast cancer. Breast Cancer Res Treat, 126, 101-8. https://doi.org/10.1007/s10549-010-1286-0
  30. Rollins KD, Lindley C, (2005). Pemetrexed: a multitargeted antifolate. Clin Ther, 27, 1343-82. https://doi.org/10.1016/j.clinthera.2005.09.010
  31. Scagliotti GV, Parikh P, von Pawel J, et al (2008). Phase III study comparing cisplatin plus gemcitabine with cisplatin pluspemetrexed in chemotherapy-naive patients with advanced-stage non-small-cell lung cancer. J Clin Oncol, 26, 3543-51. https://doi.org/10.1200/JCO.2007.15.0375
  32. Sehouli J, Camara O, Mahner S, (2010). A phase I trial of pemetrexed plus carboplatin in recurrent ovarian cancer. Cancer Chemotherapy Pharmacol, 66, 861-8. https://doi.org/10.1007/s00280-009-1230-3
  33. Seiwert TY, Connell PP, Mauer AM, et al (2007). A phase I study of pemetrexed, carboplatin, and concurrent radiotherapy in patients with locally advanced or metastatic non-small cell lung or esophageal cancer. Clin Cancer Res, 13, 515-22. https://doi.org/10.1158/1078-0432.CCR-06-1058
  34. Siegel R, Naishadham D, Jemal A, (2013). Cancer statistics, 2013. CA Cancer J Clin, 63, 11-30. https://doi.org/10.3322/caac.21166
  35. Vaughan S, Coward JI, Bast RC Jr, et al (2011). Rethinking ovarian cancer: recommendations for improving outcomes. Nat Rev Cancer, 11, 719-25. https://doi.org/10.1038/nrc3144
  36. Wu XY, Huang XE, You SX, et al (2013). Phase II study of pemetrexed as second or third line combined chemotherapy in patients with colorectal cancer. Asian Pac J Cancer Prev, 14, 2019-22. https://doi.org/10.7314/APJCP.2013.14.3.2019
  37. Zhang LQ, Xu XS, Wan Y, et al (2015). Prognostic implications of estrogen receptor 1 and vascular endothelial growth factor A expression in primary gallbladder carcinoma. World J Gastroenterol, 21, 1243-50. https://doi.org/10.3748/wjg.v21.i4.1243

Cited by

  1. Safety and Efficacy of a Mouth-Rinse with Granulocyte Colony Stimulating Factor in Patients with Chemotherapy-Induced Oral Mucositis vol.17, pp.1, 2016, https://doi.org/10.7314/APJCP.2016.17.1.413
  2. A Clinical Study on Juheli (Recombinant Human Interleukin - 11) in the Second Prevention of Chemotherapy Induced Thrombocytopenia vol.17, pp.2, 2016, https://doi.org/10.7314/APJCP.2016.17.2.485