内容紹介
Analysis of Pemetrexed Monotherapy in Advanced Non-Small Cell Lung Cancer Patients with Impaired Renal Function
Summary
Toxicity and efficacy of pemetrexed monotherapy in advanced non-small-cell lung cancer patients with impaired renal function treated between May 2009 and May 2012 at Gifu University Hospital were retrospectively analyzed. A total of 10 and 17 patients had a creatinine clearance rate(Ccr)of<45 mL/min and≥45 mL/min, respectively. The median age was higher in the Ccr<45 mL/min group(78.9 years)than in the≥45 mL/min group(65.2 years). The rate of neutropenia above Grade 3 was 30% in the Ccr<45 mL/min group and 6% in the≥45 mL/min group. Therefore, reducing the dose of pemetrexed should be considered in patients with impaired renal function. Non-hematologic toxicities were not correlated with the renal function. There was no treatment-related death, and most of the toxicities were mild and tolerable. Stable disease was observed in 6 patients(60%)in the Ccr<45 mL/min group, and in 12 patients(70%)in the Ccr≥45 mL/min group, although some patients in both groups showed neither complete nor partial responses. The disease control rate and median progression-free survival time were 60% and 2.8 months in the Ccr<45 mL/min group, and 70% and 2.9 months in the Ccr≥45 mL/min group, respectively. Thus, in this analysis, treatment with pemetrexed resulted in clinically equivalent efficacy in advanced non-small-cell lung cancer patients regardless of the state of renal function.
要旨
2009年5月～2012年5月に岐阜大学医学部附属病院において進行非小細胞肺癌に対して,pemetrexed(PEM)単剤療法(維持療法を除く)を施行した27例を対象に,腎機能低下群[クレアチニン・クリアランス(Ccr)45 mL/min未満]10例と腎機能非低下群(Ccr 45 mL/min以上)17例について安全性・有効性を後方視的に検討した。年齢中央値は腎機能低下群78.9歳,腎機能非低下群65.2歳で,腎機能低下群が有意に高齢であった。Grade 3以上の好中球減少は,腎機能低下群30%,腎機能非低下群6%で認め,腎機能低下例では好中球減少症の頻度が高く,投与の際は減量を検討するなど注意が必要と考えられた。非血液毒性は両群間で差は認めなかった。治療関連死は認めず,血液毒性・非血液毒性ともに忍容可能であった。治療効果については,病勢制御率および無増悪生存期間中央値は腎機能低下群ではそれぞれ60%,2.8か月,腎機能非低下群では70%,2.9か月であり,腎機能低下群でも非低下群とほぼ同等の効果が得られた。
目次
Summary
Toxicity and efficacy of pemetrexed monotherapy in advanced non-small-cell lung cancer patients with impaired renal function treated between May 2009 and May 2012 at Gifu University Hospital were retrospectively analyzed. A total of 10 and 17 patients had a creatinine clearance rate(Ccr)of<45 mL/min and≥45 mL/min, respectively. The median age was higher in the Ccr<45 mL/min group(78.9 years)than in the≥45 mL/min group(65.2 years). The rate of neutropenia above Grade 3 was 30% in the Ccr<45 mL/min group and 6% in the≥45 mL/min group. Therefore, reducing the dose of pemetrexed should be considered in patients with impaired renal function. Non-hematologic toxicities were not correlated with the renal function. There was no treatment-related death, and most of the toxicities were mild and tolerable. Stable disease was observed in 6 patients(60%)in the Ccr<45 mL/min group, and in 12 patients(70%)in the Ccr≥45 mL/min group, although some patients in both groups showed neither complete nor partial responses. The disease control rate and median progression-free survival time were 60% and 2.8 months in the Ccr<45 mL/min group, and 70% and 2.9 months in the Ccr≥45 mL/min group, respectively. Thus, in this analysis, treatment with pemetrexed resulted in clinically equivalent efficacy in advanced non-small-cell lung cancer patients regardless of the state of renal function.
要旨
2009年5月～2012年5月に岐阜大学医学部附属病院において進行非小細胞肺癌に対して,pemetrexed(PEM)単剤療法(維持療法を除く)を施行した27例を対象に,腎機能低下群[クレアチニン・クリアランス(Ccr)45 mL/min未満]10例と腎機能非低下群(Ccr 45 mL/min以上)17例について安全性・有効性を後方視的に検討した。年齢中央値は腎機能低下群78.9歳,腎機能非低下群65.2歳で,腎機能低下群が有意に高齢であった。Grade 3以上の好中球減少は,腎機能低下群30%,腎機能非低下群6%で認め,腎機能低下例では好中球減少症の頻度が高く,投与の際は減量を検討するなど注意が必要と考えられた。非血液毒性は両群間で差は認めなかった。治療関連死は認めず,血液毒性・非血液毒性ともに忍容可能であった。治療効果については,病勢制御率および無増悪生存期間中央値は腎機能低下群ではそれぞれ60%,2.8か月,腎機能非低下群では70%,2.9か月であり,腎機能低下群でも非低下群とほぼ同等の効果が得られた。