title: [Analysis of Pemetrexed Monotherapy in Advanced Non-Small Cell Lung Cancer Patients with Impaired Renal Function].
abstract: Toxicity and efficacy of pemetrexed monotherapy in advanced non-small-cell lung cancer patients with impaired renal function treated between May 2009 and May 2012 at Gifu University Hospital were retrospectively analyzed. A total of 10 and 17 patients had a creatinine clearance rate (Ccr) of <45 mL/min and ≥45 mL/min, respectively. The median age was higher in the Ccr<45 mL/min group (78.9 years) than in the ≥45 mL/min group (65.2 years). The rate of neutropenia above Grade 3 was 30% in the Ccr<45 mL/min group and 6% in the ≥45 mL/min group. Therefore, reducing the dose of pemetrexed should be considered in patients with impaired renal function. Non-hematologic toxicities were not correlated with the renal function. There was no treatment-related death, and most of the toxicities were mild and tolerable. Stable disease was observed in 6 patients (60%) in the Ccr<45 mL/min group, and in 12 patients (70%) in the Ccr≥45 mL/min group, although some patients in both groups showed neither complete nor partial responses. The disease control rate and median progression-free survival time were 60% and 2.8 months in the Ccr<45 mL/min group, and 70% and 2.9 months in the Ccr≥45 mL/min group, respectively. Thus, in this analysis, treatment with pemetrexed resulted in clinically equivalent efficacy in advanced non-small-cell lung cancer patients regardless of the state of renal function.
authors.affiliation: Dept. of Respiratory Medicine, Murakami Memorial Hospital, Asahi University.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Funaguchi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Nakajima
authors.forename: Daizo
authors.initials: D
authors.lastname: Kaito
authors.forename: Komei
authors.initials: K
authors.lastname: Yanase
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Ito
authors.forename: Junki
authors.initials: J
authors.lastname: Endo
authors.forename: Megumi
authors.initials: M
authors.lastname: Morishita
authors.forename: Masahiro
authors.initials: M
authors.lastname: Asano
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Iihara
authors.forename: Hidenori
authors.initials: H
authors.lastname: Mori
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ohno
authors.forename: Shinya
authors.initials: S
authors.lastname: Minatoguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D005260:Female; D005971:Glutamates / Q000009:adverse effects / Q000627:therapeutic use*; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed; D051437:Renal Insufficiency / Q000139:chemically induced / Q000503:physiopathology*; D012189:Retrospective Studies
chemical_list: D000964:Antimetabolites, Antineoplastic; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine