title: [Pemetrexed salvage chemotherapy for NSCLC: implementation study].
abstract: BACKGROUND
  Registration trials demonstrated the activity of pemetrexed in non small cell lung carcinoma (NSCLC) either in combination with first-line agents or in monotherapy for salvage treatment. The aim of our implementation study was to verify, in an unselected population, the results obtained with pemetrexed salvage chemotherapy in clinical practice.
  
  
  METHODS
  The charts of all patients diagnosed with NSCLC, receiving pemetrexed for progressive disease after at least one previous course of chemotherapy, were retrospectively reviewed in two academic institutions. Response was assessed according to WHO and toxicity using the CTCAE and WHO criteria.
  
  
  RESULTS
  Between November 2004 and September 2009, 84 patients were given pemetrexed as second, third or greater than third line therapy (n=18/14/52). Intent-to-treat response rate was 11.9% (95% CI, 5%-18.8%). Median progression-free survival was 2.2 months and median survival time was 6.4 months. The most frequent grade 3-5 toxicity was neutropenia (23.9%).
  
  
  CONCLUSIONS
  Salvage chemotherapy with pemetrexed for progressing NSCLC confirmed, in an unselected population, who had been extensively treated previously, the level of activity observed in registration trials although a significant toxicity was noted.
authors.affiliation: Département des soins intensifs et oncologie thoracique, centre des tumeurs, institut Jules-Bordet, université Libre de Bruxelles, 1, rue Heger-Bordet, 1000 Bruxelles, Belgique.
authors.forename: C
authors.initials: C
authors.lastname: Jungels
authors.forename: T
authors.initials: T
authors.lastname: Berghmans
authors.forename: A P
authors.initials: AP
authors.lastname: Meert
authors.forename: J J
authors.initials: JJ
authors.lastname: Lafitte
authors.forename: A
authors.initials: A
authors.lastname: Scherpereel
authors.forename: J P
authors.initials: JP
authors.lastname: Sculier
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D018450:Disease Progression; D005260:Female; D005971:Glutamates / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D019983:Guideline Adherence; D006284:Health Plan Implementation; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed; D012189:Retrospective Studies; D016879:Salvage Therapy; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine