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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