Clinical Data Suggest Potential Versatility of Pemetrexed-Based Regimens in Lung Cancer

Pemetrexed (Alimta) showed additional utility in the treatment of non–small-cell lung cancer (NSCLC), according to data presented at the 43rd Annual Meeting of the American Society of Clinical Oncology (ASCO) in Chicago (abstract 7517). Results from a phase III study suggest that a first-line pemetrexed-based regimen may deliver less toxicity than a commonly used therapy in advanced NSCLC.

A prospective, randomized, multicenter phase III study was conducted to compare pemetrexed plus carboplatin with the commonly used regimen of gemcitabine (Gemzar) plus carboplatin. The study, conducted by the Norwegian Lung Cancer Group, enrolled 446 chemonaive patients with stage IIIB/IV NSCLC. The primary purpose of the study was to evaluate if pemetrexed/carboplatin provided increased quality-of-life benefits while offering comparable survival data. As such, the primary endpoint was quality of life (defined as nausea/vomiting, dyspnea, and fatigue) and the secondary endpoint was overall survival.

At the time the study was reported, 384 patients had been analyzed for toxicity and fewer patients in the pemetrexed arm had experienced grade 3/4 thrombocytopenia (48 vs 107, P < .001), leukopenia (44 vs 89, P < .001), and granulocytopenia (78 vs 98, P = .02). More patients in the gemcitabine arm received transfusion of platelets (5 vs 19, P = .02). No difference in survival had been observed.

"The patients in this study received a comparable quality-of-life benefit whether they received Alimta and carboplatin or Gemzar and carboplatin," said Bjorn Henning Gronberg, MD, of St. Olavs University Hospital in Norway and the study's principal investigator. "Patients on the Alimta arm also appeared to benefit from a lower toxicity profile."