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Trial data suggest that patients with non-squamous non-small cell lung cancer have better survival with second-line pemetrexed therapy than with docetaxel

Patients with advanced, non-squamous non-small cell lung cancer survive significantly longer with pemetrexed as second-line therapy than with docetaxel, according to a presentation at the annual European Cancer Conference.

The retrospective analysis of Phase III data involved 571 patients and showed that pemetrexed patients achieved a statistically higher overall survival than peers treated with docetaxel (9.3 months and 8.0 months, respectively). Conversely, the analysis suggested that patients with a squamous histology treated with docetaxel had a statistically higher overall survival than peers treated with pemetrexed (7.4 months and 6.2 months respectively). The majority of patients in the analysis had non-squamous histology.

The retrospective analysis was driven by preclinical data that suggested patients with a lower expression of thymidylate synthase enzyme have increased efficacy when treated with pemetrexed. Adenocarcinoma and large cell carcinoma account for approximately 55 percent of all non-small cell lung cancer diagnoses.

"This particular analysis suggests that histology may play an important role in determining patients who are most likely to receive a larger treatment result from pemetrexed," said Patrick Peterson, PhD, principal research scientist at Lilly and principal author of the analysis.

Patients in the pemetrexed arm were treated with 500 mg/m2 supplemented with vitamin B12 and folic acid. Patients on the docetaxel arm were treated with 75 mg/m2.

Data from a second trial (Abstract # 6560) detailed additional predictive factors for potential benefit from treatment with pemetrexed. In a Phase II prospective study, researchers in Japan evaluated the survival outcomes of 216 patients with locally advanced or metastatic non-small cell lung cancer who were treated with second-line pemetrexed. The data suggested that favorable predictive factors could include female sex, adenocarcinoma histology; a longer interval since previous chemotherapy treatment, good performance status, diagnosis in an early clinical stage.


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