Journal Information
Vol. 34. Issue 4.
Pages 194-203 (January 2010)
Vol. 34. Issue 4.
Pages 194-203 (January 2010)
Original article
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Study of use of pemetrexed in non-small cell lung cancer
Estudio de utilización de pemetrexed en el cáncer de pulmón no microcítico
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S. Villanueva-Herraiza,
Corresponding author
villanueva_san@gva.es

Corresponding author.
, M.P. Ortega-Garcíaa, C. Camps-Herrerob, P. Blasco-Seguraa
a Servicio de Farmacia, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
b Servicio de Oncología Médica, Consorcio Hospital General Universitario de Valencia, Valencia, Spain
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Abstract
Objective

To study the effectiveness and safety of pemetrexed in non-small cell lung cancer.

Method

Retrospective study (March 2006-May 2008) of pemetrexed use. Information was obtained from the Access database belonging to the Pharmacy and Oncology Departments, the registry of external consultations and clinical histories. Data were analysed using SPSS software version 12.0. Quantitative variables are expressed as the median (minimum-maximum).

Results

The study included 44 patients (61.7 [39–77] years old), mostly male (86%), smokers or former smokers (80%) with predominantly epidermoid/squamous disease (46%) or adenocarcinoma, in a good functional state (86%) and in stage ≥III upon beginning pemetrexed treatment (93%). Prior treatment with taxanes and taxane treatment along with a prior history of neutropoenia were the criteria for changing to pemetrexed in 34.4% and 22.7% of the patients, respectively. None of the patients presented a complete or partial response: 18.2% showed disease stability and 81.8% showed disease progression. The main reasons for discontinuing pemetrexed were progression of the disease (54.5%) and worsening of symptoms (15.9%). Median survival after beginning chemotherapy was 22.2 months (ranging from 16–28.4) and 7.8 months (4.4–11.2) after beginning pemetrexed treatment. These last figures were significantly higher in women and those with an ECOG of 0 to 1. The most common adverse effects were weakness and neurotoxicity.

Conclusion

In each of the cases, pemetrexed was used as a second-line treatment or higher with a good safety profile. A complete or partial response was not reached in any of the cases, but survival after beginning pemetrexed was equal to or longer than that achieved in other studies.

Keywords:
Pemetrexed
Non small cell lung cancer
Retrospective study
Observational study
Effectiveness
Safety
Resumen
Objetivo

Estudiar la efectividad y la seguridad del pemetrexed en el cáncer de pulmón no microcítico.

Método

Estudio retrospectivo (marzo 2006-mayo 2008) de utilización de pemetrexed. Se obtuvo la información de bases de datos Access de los Servicios de Farmacia y Oncología, del registro de visitas a consultas externas y de la historia clínica. Los datos se analizaron con SPSS v. 12.0. Las variables cuantitativas se expresaron con la mediana (mínimo máximo).

Resultados

Fueron 44 pacientes (61,7 años [39–77]) la mayoría hombres (86%), fumadores/exfumadores (80%), histología epidermoide/escamosa (46%) o adenocarcinoma (36%), con buen estado funcional (86%) y estadio III o superior al inicio del tratamiento con pemetrexed (93%). El tratamiento previo con taxanos y éste junto con la neutropenia previa fueron los criterios de cambio a pemetrexed en el 34,4 y el 22,7% de los pacientes, respectivamente. Ningún paciente presentó respuesta completa o parcial; el 18,2% mostró enfermedad estable y el 81,8% progresión de la enfermedad, siendo los principales motivos de retirada del pemetrexed la progresión de la enfermedad (54,5%) y el empeoramiento clínico (15,9%). La mediana de supervivencia desde el inicio de la quimioterapia fue de 22,2 meses (16–28,4) y desde el inicio con pemetrexed fue de 7,8 meses (4,4–11,2), siendo ésta significativamente mayor en las mujeres y de aquellos con valor 0–1 en la escala Eastern Cooperative Oncology Group. Los efectos adversos más frecuentes fueron astenia y neurotoxicidad.

Conclusión

Pemetrexed se ha utilizado en todos los casos como segunda línea o superior con buen perfil de seguridad. En ningún caso se alcanzó respuesta completa o parcial, pero la supervivencia desde el inicio de pemetrexed iguala o supera a la de otros estudios.

Palabras clave:
Pemetrexed
Cáncer de pulmón no microcítico
Estudio retrospectivo
Estudio observacional
Efectividad
Seguridad
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Copyright © 2010. Sociedad Española de Farmacia Hospitalaria
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