title: Upfront association of carboplatin plus pemetrexed in patients with brain metastases of lung adenocarcinoma.
abstract: Approximately 10% of patients with non-small cell lung cancer (NSCLC) have brain metastases at the time of diagnosis. When surgical resection is not possible, whole brain radiotherapy is the standard of care, with a cerebral response rate of approximately 30%. We report our experience with an upfront association of carboplatin and pemetrexed (areas under the curve, 5 and 500 mg/m(2), respectively), every 3 weeks, in 30 patients presenting with newly diagnosed brain metastases and NSCLC. Cerebral MRIs were performed every 6-9 weeks. The radiologic response rates were assessed according to Response Evaluation Criteria in Solid Tumors. Overall survival was also determined. Twenty-six patients were evaluable for response, and the objective cerebral response rate (complete and partial response) in the intent-to-treat population was 40% (12 of 30 patients). Event-free survival was 31 weeks, and median overall survival was 39 weeks. The upfront association of carboplatin plus pemetrexed allows simultaneous treatment of cerebral and systemic disease in patients with NSCLC with newly diagnosed brain metastases and appears to be particularly interesting in terms of radiologic response and overall survival. Further clinical studies are warranted.
authors.affiliation: Assistance Publique-Hôpitaux de Paris, Hôpital Avicenne, Service de Neurologie, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bailon
authors.forename: Kader
authors.initials: K
authors.lastname: Chouahnia
authors.forename: Alexandre
authors.initials: A
authors.lastname: Augier
authors.forename: Thierry
authors.initials: T
authors.lastname: Bouillet
authors.forename: Ségolène
authors.initials: S
authors.lastname: Billot
authors.forename: Irène
authors.initials: I
authors.lastname: Coman
authors.forename: Rénata
authors.initials: R
authors.lastname: Ursu
authors.forename: Catherine
authors.initials: C
authors.lastname: Belin
authors.forename: Laurent
authors.initials: L
authors.lastname: Zelek
authors.forename: Gaëtan
authors.initials: G
authors.lastname: Des Guetz
authors.forename: Christine
authors.initials: C
authors.lastname: Levy
authors.forename: Antoine F
authors.initials: AF
authors.lastname: Carpentier
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Morere
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000077192:Adenocarcinoma of Lung; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary; D016190:Carboplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D016190:Carboplatin