title: Pemetrexed versus vinorelbine treatment of advanced non-squamous non-small cell lung cancer in elderly patients.
abstract: Pemetrexed, a multitargeted antifolate agent, has been shown to have clear activity in non-squamous non-small cell lung cancer (NSCLC). The aim of this retrospective studywas to evaluated the efficacy and toxicity of pemetrexed vs. vinorelbine in NSCLC elderly patients. Chemotherapy-naive patients aged ≥70 years with stage IIIB/IV non-squamous NSCLC and performance status ≤2 were eligible for inclusion in this study. Patients were selected to receive pemetrexed 500 mg/m2(day 1) or vinorelbine 25 mg/m2(days 1 and 8) every 21 days. In total, 62 patients were enrolled in the present study. Thirty-six patients were treated with pemetrexed, and 26 with vinorelbine. The median number of cycles received was six in the pemetrexed group vs. four in the vinorelbine group. Pemetrexed demonstrated a significantly higher disease control rate (DCR) (80.5 vs. 65.3%; P=0.011), and an improvement in progression-free survival (6.5 vs. 4.0 months; P=0.018) compared to vinorelbine. Neutropenia occurred in more patients in the vinorelbine group compared to the pemetrexed group, grade 3-4 neutropenia was observed in 53.8 and 11.1% of patients in the two groups, respectively (P<0.001). Pemetrexed-treated patients experienced lower frequencies of anemia, thrombocytopenia and non-hematologic toxicities compared to vinorelbine-treated patients. The toxicity profiles for the two treatment groups were mild and tolerable. In conclusion, pemetrexed improved DCR, progression-free survival, and presented a lower incidence of treatment-related adverse events compared to vinorelbine, although overall survival was not significantly improved. As a result, pemetrexed monotherapy might be considered as a good option in the treatment of elderly patients with advanced non-squamous NSCLC.
authors.affiliation: Department of Clinical Oncology, Henan Tumor Hospital, Zhengzhou University Affiliated Tumor Hospital, Zhengzhou University, Zhengzhou, Henan 450008;
authors.forename: Yongshun
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Clinical Oncology, Affiliated Hospital of Luzhou Medical College, Lizhou, Sichuan 646000;
authors.forename: Qinglian
authors.initials: Q
authors.lastname: Wen
authors.affiliation: Department of Clinical Oncology, Sichuan People's Hospital, Chengdu, Sichuan 610072, P.R. China.
authors.forename: Hao
authors.initials: H
authors.lastname: Liu
authors.affiliation: Department of Clinical Oncology, Sichuan People's Hospital, Chengdu, Sichuan 610072, P.R. China.
authors.forename: Rui
authors.initials: R
authors.lastname: Ao
authors.affiliation: Department of Clinical Oncology, Henan Tumor Hospital, Zhengzhou University Affiliated Tumor Hospital, Zhengzhou University, Zhengzhou, Henan 450008;
authors.forename: Xiaoyuan
authors.initials: X
authors.lastname: Wu
authors.affiliation: Department of Clinical Oncology, Henan Tumor Hospital, Zhengzhou University Affiliated Tumor Hospital, Zhengzhou University, Zhengzhou, Henan 450008;
authors.forename: Leiming
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Clinical Oncology, Henan Tumor Hospital, Zhengzhou University Affiliated Tumor Hospital, Zhengzhou University, Zhengzhou, Henan 450008;
authors.forename: Wen
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Clinical Oncology, Henan Tumor Hospital, Zhengzhou University Affiliated Tumor Hospital, Zhengzhou University, Zhengzhou, Henan 450008;
authors.forename: Chunyu
authors.initials: C
authors.lastname: He
authors.affiliation: Department of Clinical Oncology, Henan Tumor Hospital, Zhengzhou University Affiliated Tumor Hospital, Zhengzhou University, Zhengzhou, Henan 450008;
authors.forename: Jianhua
authors.initials: J
authors.lastname: Wang
keywords: elderly; first-line therapy; lung cancer; pemetrexed; vinorelbine