title: Pemetrexed in patients with locally advanced or metastatic breast cancer who had received previous anthracycline and taxane treatment: phase II study.
abstract: OBJECTIVE
  The objective of this study was to assess the efficacy and safety of pemetrexed in pretreated patients with advanced-stage breast cancer.
  
  
  METHODS
  Patients with advanced-stage or metastatic breast cancer, Eastern Cooperative Oncology Group performance status 0-2, and progressive or relapsed disease after treatment with regimens containing anthracyclines and taxanes were eligible. Pemetrexed 500 mg/m2 was administered as a 10-minute intravenous infusion on day 1 every 21 days.
  
  
  RESULTS
  Seventy-nine women were enrolled. After protocol amendment, 43 patients received folic acid and vitamin B12 supplementation to control pemetrexed-related toxicity. A median of 4 cycles (range, 1-23 cycles) was administered. Overall response rate was 9% (95% confidence interval, 3.7%-17.6%), median duration of response was 5.5 months, median progression-free survival was 3.1 months, and median survival was 10.5 months. Major grade 3/4 toxicities were lymphopenia (53.3%), neutropenia (36.4%), leukopenia (26.9%), and anemia (7.7%). In general, the toxicities were less frequent in patients who received vitamin supplementation than in those who did not receive vitamin supplementation.
  
  
  CONCLUSIONS
  The response to pemetrexed salvage treatment was low in this study of heavily pretreated patients with breast cancer. Pemetrexed was generally well tolerated in patients with previously treated breast cancer. Vitamin supplementation appeared to ameliorate toxicity.
authors.affiliation: Instituto Valenciano de Oncologia, Valencia, Spain. allombart@arnau.scs.es
authors.forename: Antonio
authors.initials: A
authors.lastname: Llombart-Cussac
authors.forename: Maria
authors.initials: M
authors.lastname: Theodoulou
authors.forename: Kendrith
authors.initials: K
authors.lastname: Rowland
authors.forename: Romnee S
authors.initials: RS
authors.lastname: Clark
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Eva
authors.initials: E
authors.lastname: Carrasco
authors.forename: Giorgio
authors.initials: G
authors.lastname: Cruciani
mesh_terms: D000328:Adult; D000368:Aged; D018943:Anthracyclines / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D001952:Bridged-Ring Compounds / Q000627:therapeutic use; D005260:Female; D005492:Folic Acid / Q000627:therapeutic use; D005971:Glutamates / Q000009:adverse effects / Q000627:therapeutic use*; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000188:drug therapy; D009367:Neoplasm Staging; D000068437:Pemetrexed; D011292:Premedication; D016879:Salvage Therapy; D043823:Taxoids / Q000627:therapeutic use; D014805:Vitamin B 12 / Q000627:therapeutic use*; D014803:Vitamin B Complex / Q000627:therapeutic use
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D001952:Bridged-Ring Compounds; D005971:Glutamates; D043823:Taxoids; D000068437:Pemetrexed; D014803:Vitamin B Complex; C080625:taxane; D006147:Guanine; D005492:Folic Acid; D014805:Vitamin B 12