title: Phase II Study of High-Dose Pemetrexed Plus Cisplatin as First-Line Chemotherapy In the Treatment of Patients with Brain Metastases from Lung Adenocarcinoma.
abstract: BACKGROUND
  Brain metastases (BMs) occur in up to 40% of patients with nonsmall-cell lung cancer (NSCLC). When surgery or radiosurgery is not possible, whole-brain radiotherapy (WBRT) is the standard treatment, with a cerebral response rate of approximately 30%. Pemetrexed-based chemotherapy presents an approximately 40% response rate on brain lesions of NSCLC with brain metastases.
  
  
  METHODS
  This trial assessed the efficacy and safety of high-dose pemetrexed plus cisplatin in NSCLC with BMs after WBRT. Thirty-two patients with Karnofsky Performance Status ≥70 were enrolled. Patients of NSCLC with brain metastases were eligible for WBRT, which was administered at 30 Gy/10f. Thereafter, high-dose pemetrexed plus cisplatin was given up to 6 cycles. Primary end point was objective response rate (RR) and progression-free survival on BM. Secondary end points included extracerebral and overall RR, safety profile, and survival.
  
  
  RESULTS
  The objective cerebral RR (complete and partial response) was 68.8 % (22 of 32 patients). Extracerebral and globe RR was 37.5% and 31.3%, respectively. The median progression-free survival of BM was 13.6 months, and median overall survival was 19.1 months.
  
  
  CONCLUSIONS
  This modality of treatment appears to a better efficacy and a good safety of BM, as well as extracerebral. Further clinical studies are warranted.
authors.affiliation: Department of Neurosurgery, Qingdao University affiliated Yantai Yuhuangding Hospital, Shandong Province, P. R. China.
authors.forename: Qiaowei
authors.initials: Q
authors.lastname: He
authors.affiliation: Department of Neurosurgery, Shandong Cancer Hospital, Shandong Province, P. R. China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Qingdao University affiliated Yantai Yuhuangding Hospital, Shandong Province, P. R. China.
authors.forename: Peng
authors.initials: P
authors.lastname: Zou
authors.affiliation: Department of Neurosurgery, Qingdao University affiliated Yantai Yuhuangding Hospital, Shandong Province, P. R. China.
authors.forename: Yunbo
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Qingdao University affiliated Yantai Yuhuangding Hospital, Shandong Province, P. R. China.
authors.forename: Chunming
authors.initials: C
authors.lastname: Xiu
authors.affiliation: Department of Neurosurgery, Qingdao University affiliated Yantai Yuhuangding Hospital, Shandong Province, P. R. China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Neurosurgery, Qingdao University affiliated Yantai Yuhuangding Hospital, Shandong Province, P. R. China.
authors.forename: Nan
authors.initials: N
authors.lastname: Chi
authors.affiliation: Department of Neurosurgery, Qingdao University affiliated Yantai Yuhuangding Hospital, Shandong Province, P. R. China.
authors.forename: Haining
authors.initials: H
authors.lastname: Zou
authors.affiliation: Department of Neurosurgery, Shandong Cancer Hospital, Shandong Province, P. R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Shandong Cancer Hospital, Shandong Province, P. R. China.
authors.forename: Shizhen
authors.initials: S
authors.lastname: Zhou
authors.affiliation: Department of Neurosurgery, Shandong Cancer Hospital, Shandong Province, P. R. China. Electronic address: 053113969191909@163.com.
authors.forename: Rongjie
authors.initials: R
authors.lastname: Tao
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary; D002945:Cisplatin / Q000008:administration & dosage; D016371:Cranial Irradiation; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed / Q000008:administration & dosage; D015996:Survival Rate
chemical_list: D000068437:Pemetrexed; D002945:Cisplatin
keywords: Brain; Chemotherapy; High-dose pemetrexed; Lung adenocarcinoma; Metastases; WBRT