内容紹介
Efficacy and Toxicity of Pemetrexed Monotherapy for Previously Untreated Elderly Patients with Non-Squamous Cell Lung Cancer with Wild-Type(or Unknown)EGFR Status
Summary
Background: The efficacy of docetaxel, vinorelbine, or gemcitabine monotherapy in previously untreated elderly patients with non-small cell lung cancer has been reported. Pemetrexed monotherapy has shown clinically equivalent efficacy to docetaxel, a standard therapeutic option, in patients with previously treated non-small cell lung cancer and in those with a lower incidence of toxicity such as febrile neutropenia. Objective: In the present study, we aimed to investigate the efficacy and toxicity of pemetrexed in previously untreated elderly patients with non-squamous cell lung cancer and compare the results with those of docetaxel, considered a standard chemotherapeutic agent. Methods: We retrospectively reviewed the medical records of patients with non-squamous cell lung cancer with wild-type(or unknown)epidermal growth factor receptor status who received pemetrexed or docetaxel monotherapy as first-line chemotherapy. Results: We analyzed 6 patients with lung adenocarcinoma in the pemetrexed group and 6 patients with lung adenocarcinoma in the docetaxel group. The median progression-free survival was 3.6 months for patients receiving pemetrexed and 3.1 months for those receiving docetaxel(p=0.45). The median overall survival was 14.8 months in the pemetrexed group and 10.9 months in the docetaxel group(p=0.36). Patients who received docetaxel were more likely to have grade 3 or 4 neutropenia and febrile neutropenia than those receiving pemetrexed. However, 2 patients who received pemetrexed showed grade 3 pneumonitis. Conclusion: Pemetrexed monotherapy is a promising treatment for previously untreated elderly patients with non-squamous cell lung cancer.
要旨
背景: 未治療高齢者非小細胞肺癌に対するドセタキセル,ビノレルビン,ゲムシタビンの単剤投与の有効性が報告されている。一方で,ペメトレキセドは既治療非小細胞肺癌に対して標準的治療薬であるドセタキセルとほぼ同等の効果を示し,発熱性好中球減少症などの副作用が軽度であることが報告されている。目的: 未治療高齢者非扁平上皮肺癌症例に対するペメトレキセドの使用経験をまとめ,効果と毒性を標準的治療薬であるドセタキセルと比較する。方法: 2004～2012年の間に当科において診療した70歳以上のepidermal growth factor receptor遺伝子変異陰性・不明の非扁平上皮肺癌症例で,一次治療としてペメトレキセドもしくはドセタキセルの単剤投与が行われた症例を対象とし,後ろ向きに解析した。結果: ペメトレキセド群腺癌6例とドセタキセル群腺癌6例を解析した。progression free survival中央値はペメトレキセド群3.6か月,ドセタキセル群3.1か月(p=0.45),overall survival中央値はペメトレキセド群14.8か月,ドセタキセル群10.9か月(p=0.36)であった。ドセタキセル群ではgrade 3以上の好中球減少,発熱性好中球減少症がペメトレキセド群と比較して多く認められた。一方で,ペメトレキセド群ではgrade 3の肺臓炎が2例認められた。結論: 未治療非扁平上皮肺癌症例に対するペメトレキセドの単剤投与の効果が期待される。
目次
Summary
Background: The efficacy of docetaxel, vinorelbine, or gemcitabine monotherapy in previously untreated elderly patients with non-small cell lung cancer has been reported. Pemetrexed monotherapy has shown clinically equivalent efficacy to docetaxel, a standard therapeutic option, in patients with previously treated non-small cell lung cancer and in those with a lower incidence of toxicity such as febrile neutropenia. Objective: In the present study, we aimed to investigate the efficacy and toxicity of pemetrexed in previously untreated elderly patients with non-squamous cell lung cancer and compare the results with those of docetaxel, considered a standard chemotherapeutic agent. Methods: We retrospectively reviewed the medical records of patients with non-squamous cell lung cancer with wild-type(or unknown)epidermal growth factor receptor status who received pemetrexed or docetaxel monotherapy as first-line chemotherapy. Results: We analyzed 6 patients with lung adenocarcinoma in the pemetrexed group and 6 patients with lung adenocarcinoma in the docetaxel group. The median progression-free survival was 3.6 months for patients receiving pemetrexed and 3.1 months for those receiving docetaxel(p=0.45). The median overall survival was 14.8 months in the pemetrexed group and 10.9 months in the docetaxel group(p=0.36). Patients who received docetaxel were more likely to have grade 3 or 4 neutropenia and febrile neutropenia than those receiving pemetrexed. However, 2 patients who received pemetrexed showed grade 3 pneumonitis. Conclusion: Pemetrexed monotherapy is a promising treatment for previously untreated elderly patients with non-squamous cell lung cancer.
要旨
背景: 未治療高齢者非小細胞肺癌に対するドセタキセル,ビノレルビン,ゲムシタビンの単剤投与の有効性が報告されている。一方で,ペメトレキセドは既治療非小細胞肺癌に対して標準的治療薬であるドセタキセルとほぼ同等の効果を示し,発熱性好中球減少症などの副作用が軽度であることが報告されている。目的: 未治療高齢者非扁平上皮肺癌症例に対するペメトレキセドの使用経験をまとめ,効果と毒性を標準的治療薬であるドセタキセルと比較する。方法: 2004～2012年の間に当科において診療した70歳以上のepidermal growth factor receptor遺伝子変異陰性・不明の非扁平上皮肺癌症例で,一次治療としてペメトレキセドもしくはドセタキセルの単剤投与が行われた症例を対象とし,後ろ向きに解析した。結果: ペメトレキセド群腺癌6例とドセタキセル群腺癌6例を解析した。progression free survival中央値はペメトレキセド群3.6か月,ドセタキセル群3.1か月(p=0.45),overall survival中央値はペメトレキセド群14.8か月,ドセタキセル群10.9か月(p=0.36)であった。ドセタキセル群ではgrade 3以上の好中球減少,発熱性好中球減少症がペメトレキセド群と比較して多く認められた。一方で,ペメトレキセド群ではgrade 3の肺臓炎が2例認められた。結論: 未治療非扁平上皮肺癌症例に対するペメトレキセドの単剤投与の効果が期待される。