title: Pemetrexed single agent in previously treated non-small cell lung cancer: a multi-institutional observational study.
abstract: Several drugs have been approved for the treatment of patients affected by advanced non-small cell lung cancer (NSCLC) in progression after first line chemotherapy: Docetaxel, Pemetrexed and Erlotinib. Poor gain of survival has been demonstrated in randomised trials and patient characteristics predicting activity are poorly known yet. We evaluated the activity and toxicity of Pemetrexed, in a post-registration phase, to assess whether clinical benefits justify its employment in a second-line setting in routine clinical practice.
  
  
  METHODS
  We collected data on patients with advanced NSCLC treated with Pemetrexed 500mg/m(2) every 21 days, after progression to prior chemotherapy.
  
  
  RESULTS
  One hundred and sixty patients from 4 different Italian Institutions, treated with Pemetrexed, mostly as second-line therapy, were analysed. There was a predominance of males versus females, adenocarcinoma versus other histologies; the median age was 63.6 years. The toxicity profile was extremely mild and the response rate (11.2% patients in complete or partial response) was similar to previous reports from the literature. The median overall survival, 12 months, was better than previously reported.
  
  
  CONCLUSIONS
  Improved efficacy and mild toxicity observed in this clinically relevant patient population confirms Pemetrexed as an interesting choice in second-line treatment of NSCLC. Patient characteristics alone are not able to predict response to Pemetrexed.
authors.affiliation: Medical Oncology A, IRCCS-CRO, Via Franco Gallini 2, 33081 Aviano, Italy. abearz@cro.it
authors.forename: Alessandra
authors.initials: A
authors.lastname: Bearz
authors.forename: Isabella
authors.initials: I
authors.lastname: Garassino
authors.forename: Raffaele
authors.initials: R
authors.lastname: Cavina
authors.forename: Adolfo
authors.initials: A
authors.lastname: Favaretto
authors.forename: Massimo
authors.initials: M
authors.lastname: Boccalon
authors.forename: Renato
authors.initials: R
authors.lastname: Talamini
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Berretta
authors.forename: Simon
authors.initials: S
authors.lastname: Spazzapan
authors.forename: Cecilia
authors.initials: C
authors.lastname: Simonelli
authors.forename: Armando
authors.initials: A
authors.lastname: Santoro
authors.forename: Umberto
authors.initials: U
authors.lastname: Tirelli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D005971:Glutamates / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed; D012189:Retrospective Studies
chemical_list: D000964:Antimetabolites, Antineoplastic; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine