Study of Pemetrexed-based Chemotherapy for Patients with Locally Advanced or Metastatic Cancers


Purpose: This study was conducted to observe the efficacy and safety of pemetrexed based chemotherapyin treating patients with locally advanced or metastatic cancers as first-line, second-line or third-line therapy.Materials and
Methods: From May 2011 to January 2015, we recruited 29 patients with advanced breast cancer,19 patients with advanced ovary cancer, 17 patients with advanced esophageal cancer,5 patients with advancedgallbladder cancer,5 patients with advanced cervical cancer and 1 patient with advanced tongue cancer inJiangsu Cancer Hospital and Research Institute.All of them were pathologically confirmed and treated withpemetrexed based chemotherapy. After two cycles of treatment,efficacy and safety can be evaluated.
Results:For pemetrexed based regimens,including 76 patients with 6 kinds of advanced cancer were considered eligiblefor inclusion. Complete remission represents CR, partial remission represents PR, stable disease represents SD,progressive disease represents PD. Among 29 patients with advanced breast cancer, 4 patients chose pemetrexedbased regimens as second-line treatment,1 of them was PR,the other 3 got SD. The last 25 patients made useof this chemotherapy as third-line treatment, except one patient could not be assessed, 2 of them got PR,6 ofthem got SD,the remaining 16 of them finally were PD.19 patients with advanced ovary cancer,5 patients usedthis regimens as second-line treatment, 3 of them got PD,the remaining patients got SD, respectively. The last14 patients made use of pemetrexed based regimens as third-line treatment,. RR (CR+PR) was 28.5%. Among17 patients with advanced esophageal cancer, 2 patients made use of pemetrexed based regimens as first-linetreatment,both of them got PR.4 of them used this chemotherapy as second-line regimen, except 2 patients couldnot be assessed,the remaining 2 was PD at last. The last 11 patients was third-line users, RR (CR+PR) was 18.2%.Among 5 patients with advanced gallbladder cancer, pemetrexed based regimens was used in 1 patient as firstlinetreatment and 1 patient as second-line treatment. The curative effect was SD and PD, respectively. 3 patientsaccepted pemetrexed based regimens as third-line treatment, 2 of them got PD as results and another was SD.Among 5 patients with advanced cervical cancer, just 1 patient adopted pemetrexed based regimens as first-linetreatment, whose curative effect was PR.2 patients chose this chemotherapy regimens as second-line treatment.Both of them got PD as their consequence. The last 2 patients made use of the regimens as third-line treatment,the effect of them was PD and SD, respectively. The one who with advanced tongue cancer, pemetrexed basedregimens was used as second-line treatment, and the consequence was PD. About 71.1% patients experienced bonemarrow suppression. Among them, 5 patients reached 4 grade. Other toxicity of pemetrexed were neurotoxicity,fatigue, diarrhea, dysphagia and vomiting. No treatment related death occurred with pemetrexed-based treatment.
Conclusions: Pemetrexed based chemotherapy has considerable effect in patients with advanced cancers suchas breast cancer,esophageal cancer and ovary cancer. More randomly clinical trials are needed to verify theresults.