Over the past decade many large randomized trials have been conducted in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC); however, no single regimen has shown clear superiority. Typical response rates of 17% to 32%, median survival times of 7 to 10 months, and 1-year survival rates of 30% to 45% are common in such studies. Nevertheless, metastatic NSCLC remains an incurable disease, with the development of drug resistance as a major impediment. New treatment regimens, such as the broadly used antifolate antimetabolites, target multiple metabolic functions and may lead to improvements in clinical outcome. Pemetrexed (Alimta; Eli Lilly and Co, Indianapolis, IN) is a novel antifolate, distinguished by a unique nuclear structure and its ability to inhibit multiple folate-dependent enzymatic pathways. Typically, vitamin B 12 and folic acid supplementation are incorporated into the treatment regimen to ameliorate untoward toxicities. When used either as a single agent or in combination with cis-diamine platinums (eg, cisplatin, carboplatin) or diaminocyclohexane platinums (eg, oxaliplatin), pemetrexed has shown significant antitumor activity, with mild, manageable toxicity in patients with advanced NSCLC.
Pemetrexed plus carboplatin or oxaliplatin in advanced non-small cell lung cancer.
SCAGLIOTTI, Giorgio Vittorio
2005-01-01
Abstract
Over the past decade many large randomized trials have been conducted in patients with locally advanced or metastatic non-small cell lung cancer (NSCLC); however, no single regimen has shown clear superiority. Typical response rates of 17% to 32%, median survival times of 7 to 10 months, and 1-year survival rates of 30% to 45% are common in such studies. Nevertheless, metastatic NSCLC remains an incurable disease, with the development of drug resistance as a major impediment. New treatment regimens, such as the broadly used antifolate antimetabolites, target multiple metabolic functions and may lead to improvements in clinical outcome. Pemetrexed (Alimta; Eli Lilly and Co, Indianapolis, IN) is a novel antifolate, distinguished by a unique nuclear structure and its ability to inhibit multiple folate-dependent enzymatic pathways. Typically, vitamin B 12 and folic acid supplementation are incorporated into the treatment regimen to ameliorate untoward toxicities. When used either as a single agent or in combination with cis-diamine platinums (eg, cisplatin, carboplatin) or diaminocyclohexane platinums (eg, oxaliplatin), pemetrexed has shown significant antitumor activity, with mild, manageable toxicity in patients with advanced NSCLC.File | Dimensione | Formato | |
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