A phase II trial of pemetrexed and gemcitabine as first line therapy for poor performance status and/or elderly patients with stage IIIB/IV non-small cell lung cancer

L. Johnetta Blakely, Lee Schwartzberg, Mark Keaton, Fred Schnell, David Henry, Amanda Epperson, Mark S. Walker

Research output: Contribution to journalArticle

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Abstract

Pemetrexed and gemcitabine are both active agents for the treatment of locally advanced or metastatic NSCLC. We tested a novel biweekly combination of pemetrexed and gemcitabine for tolerability and efficacy in 45 elderly and/or poor performance status patients (44% female, mean age of 72.4 years) with measurable stage IIIB/IV NSCLC. Patients received biweekly cycles of pemetrexed 500 mg/m2 IV over 10 min followed by gemcitabine 1500 mg/m2 IV with vitamin B12 1000 μg IM, and folic acid 1 mg po daily beginning 7 days before and continuing throughout treatment (median of 4 cycles). Ten patients experienced grade 3/4 neutropenia, two had grade 3 febrile neutropenia, and two had grade 3 anemia. Patients with ECOG PS 2 appeared poorly suited for the regimen, with 61.5% completing ≤2 cycles. The overall response rate was 17.8%, the clinical benefit rate (CR + PR + SD >24 weeks) was 26.7%, and the median progression free survival was 3.5 months. However, ECOG 0-1 patients had longer PFS and tended to have a better response rate than ECOG 2 patients.

Original languageEnglish (US)
Pages (from-to)97-102
Number of pages6
JournalLung Cancer
Volume66
Issue number1
DOIs
StatePublished - Oct 1 2009

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gemcitabine
Pemetrexed
Non-Small Cell Lung Carcinoma
Therapeutics
Febrile Neutropenia
Vitamin B 12
Neutropenia
Folic Acid
Disease-Free Survival
Anemia

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

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A phase II trial of pemetrexed and gemcitabine as first line therapy for poor performance status and/or elderly patients with stage IIIB/IV non-small cell lung cancer. / Blakely, L. Johnetta; Schwartzberg, Lee; Keaton, Mark; Schnell, Fred; Henry, David; Epperson, Amanda; Walker, Mark S.

In: Lung Cancer, Vol. 66, No. 1, 01.10.2009, p. 97-102.

Research output: Contribution to journalArticle

Blakely, L. Johnetta ; Schwartzberg, Lee ; Keaton, Mark ; Schnell, Fred ; Henry, David ; Epperson, Amanda ; Walker, Mark S. / A phase II trial of pemetrexed and gemcitabine as first line therapy for poor performance status and/or elderly patients with stage IIIB/IV non-small cell lung cancer. In: Lung Cancer. 2009 ; Vol. 66, No. 1. pp. 97-102.
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