title: [Effect of pemetrexed plus platinum for chemotherapy-naive advanced non-small cell lung cancer].
abstract: OBJECTIVE
  To evaluate the effect of pemetrexed plus platinum for chemotherapy-naive advanced non-small cell lung cancer (NSCLC), and to explore thymidylate synthetase (TS) expression as the predictive and prognostic factor for this treatment.
  
  
  METHODS
  This retrospective study enrolled 51 patients with chemotherapy-naive advanced NSCLC (non-squamous) treated at Department of Thoracic Medical Oncology in Beijing Cancer Hospital from Jan 2008 to Oct 2009. All patients received pemetrexed plus platinum as first-line treatment. TS expression was detected in 30 patients who had enough tissue samples by immunohistochemistry.
  
  
  RESULTS
  The objective response rate (ORR) was 37.3%. Median progression-free survival (PFS) was 5.3 months (95%CI: 3.9 - 6.7), and median overall survival (OS) was 19.0 months (95%CI: 11.6 - 26.4). Univariate analysis showed that gender, pathology, smoking status and response were significantly correlated with OS. Cox-regression analysis showed that pathology was an independent prognostic factor. Rate of Grade 3/4 adverse events was low. In 30 patients with enough tissue samples were available, TS expression positive rate was 33.3% (10/30). Chi-square test showed that TS expression was not associated with ORR. Multivariate analysis showed that pathology, response and TS expression (P = 0.003, 0.005 and 0.001, respectively) were the prognostic factors.
  
  
  CONCLUSIONS
  The therapeutic effect and tolerance of pemetrexed plus platinum regiment were definite as first-line treatment for chemotherapy-naive advanced NSCLC, and TS expression was an independent prognostic factor.
authors.affiliation: Department of Thoracic Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors.forename: Jian-chun
authors.initials: JC
authors.lastname: Duan
authors.forename: Mei-na
authors.initials: MN
authors.lastname: Wu
authors.forename: Jun
authors.initials: J
authors.lastname: Zhao
authors.forename: Tong-tong
authors.initials: TT
authors.lastname: An
authors.forename: Lu
authors.initials: L
authors.lastname: Yang
authors.forename: Hua
authors.initials: H
authors.lastname: Bai
authors.forename: Zhi-jie
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Ming-lei
authors.initials: ML
authors.lastname: Zhuo
authors.forename: Shu-hang
authors.initials: SH
authors.lastname: Wang
authors.forename: Yu-yan
authors.initials: YY
authors.lastname: Wang
authors.forename: Xiao-hong
authors.initials: XH
authors.lastname: Liu
authors.forename: Jie
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy* / Q000378:metabolism; D005260:Female; D005971:Glutamates / Q000008:administration & dosage; D006147:Guanine / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed; D010984:Platinum / Q000008:administration & dosage; D012189:Retrospective Studies; D013940:Thymidylate Synthase / Q000032:analysis* / Q000378:metabolism; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D005971:Glutamates; D000068437:Pemetrexed; D010984:Platinum; D006147:Guanine; D013940:Thymidylate Synthase