title: Pemetrexed in the treatment of thoracic malignancies: a single centre experience in Singapore.
abstract: BACKGROUND
  This study aimed to examine the efficacy and toxicity of pemetrexed in Singapore.
  
  
  METHODS
  We conducted a retrospective review of patients treated with pemetrexed between July 2005 and November 2007. RECIST was used to assess the efficacy independent of the treating physician's assessment, and NCI CTC-AE version 3.0 was used to describe adverse events.
  
  
  RESULTS
  37 patients had non-small-cell lung cancer (NSCLC) and six had malignant pleural mesothelioma. Those with NSCLC had a median age of 60 and an ECOG PS of 0-1, and they were predominantly male, ethnic Chinese and smokers. A median of two cycles were delivered (total 95; range 1-12). Grade 3/4 toxicity was rare. Five (14 percent) patients had an objective response (one complete, four partial) and 13 (35 percent) had stable disease. Median time to treatment failure was 1.86 months (95% confidence interval [CI] 0-6.5). Median overall survival was 18.6 months (95% CI 12.6-27.7). Median age of patients with mesothelioma was 46.5 (range 29-73) years. Five men and one woman received a median of four (total 30, range 1-15) cycles of pemetrexed in combination with cisplatin. Three patients had a partial response, two had stable disease and one had disease progression. Grade 3/4 toxicities were as follows: leucopenia, neutropenia and thrombocytopenia in one patient.
  
  
  CONCLUSIONS
  The results of this retrospective study and literature review show that pemetrexed is safe and efficacious in the treatment of Asian patients with NSCLC and mesothelioma.
authors: Johns Hopkins Singapore International Medical Centre, Johns Hopkins University School of Medicine, 11 Jalan Tan Tock Seng, Level 1, Singapore 308433. glopes@imc.jhmi.edu
authors: G
authors: G
authors: Lopes
authors: A
authors: A
authors: Chopra
authors: J
authors: J
authors: Kukutschka
authors: P
authors: P
authors: Portillo
authors: L
authors: L
authors: Bharwani
authors: A
authors: A
authors: Chang
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; D005260:Female; D005971:Glutamates / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy; D008297:Male; D008654:Mesothelioma / Q000188:drug therapy; D008875:Middle Aged; D000068437:Pemetrexed; D012189:Retrospective Studies; D012846:Singapore; D013899:Thoracic Neoplasms / Q000188:drug therapy* / Q000208:ethnology; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine