title: Efficacy and toxicity profile of maintenance pemetrexed in patients with stage IV adenocarcinoma lung in Indian population.
abstract: BACKGROUND
  Lung cancer has been the most common cancer in the world for several decades. Pemetrexed is recommended as an option for the maintenance treatment in metastatic adenocarcinoma lung, if disease has not progressed immediately following platinum-based chemotherapy.
  
  
  OBJECTIVE
  To study efficacy and toxicity profile of pemetrexed as a maintenance chemotherapeutic agent in patients with stage IV adenocarcinoma lung, not progressing after first line chemotherapy. Settings and Design: This was an observational, prospective. We enrolled patients with stage IV adenocarcinoma lung who has not progressed on first line chemotherapy, from September 2013 to August 2014 at a tertiary care cancer institute in North India.
  
  
  METHODS
  In all, 108 patients with stage IV adenocarcinoma lung were started on induction pemetrexed/platinum chemotherapy. 60 patients with no disease progression & ECOG PS 0-2 were started on Pemetrexed maintenance. Progression free survival (PFS) and toxicity profile were recorded.
  
  
  RESULTS
  The mean number of maintenance cycles was 8.3 (range 2-28). 13 (21.6%) patients took >10 maintenance cycles. Pemetrexed maintenance therapy resulted in progression free survival (PFS) of 5.4 months. PFS on pemetrexed was consistent for all patient subgroups, including induction response: complete/partial responders (n-31) and stable disease (n-29). 14 patients had grade III/IV adverse events with anemia being the most common in 3/60 patients (5%). 3 patients (5%) developed renal dysfunction out of which 1 was grade III.
  
  
  CONCLUSIONS
  Pemetrexed continuation maintenance chemotherapy is active and well tolerated. Pemetrexed maintenance should be considered in patients with advanced adenocarcinoma lung patients who have not progressed on completion of induction chemotherapy.
authors.affiliation: Department of Medical Oncology, Rajiv Gandhi Cancer Institute, Rohini, New Delhi, India.
authors.forename: Goyal
authors.initials: G
authors.lastname: Pankaj
authors.affiliation: Department of Medical Oncology, Rajiv Gandhi Cancer Institute, Rohini, New Delhi, India.
authors.forename: Batra
authors.initials: B
authors.lastname: Ullas
authors.affiliation: Department of Medical Oncology, Rajiv Gandhi Cancer Institute, Rohini, New Delhi, India.
authors.forename: Dinesh Chandra
authors.initials: DC
authors.lastname: Doval
authors.affiliation: Department of Medical Oncology, Rajiv Gandhi Cancer Institute, Rohini, New Delhi, India.
authors.forename: Jain
authors.initials: J
authors.lastname: Parveen
authors.affiliation: Department of Medical Oncology, Rajiv Gandhi Cancer Institute, Rohini, New Delhi, India.
authors.forename: Upadhyay Kumar
authors.initials: UK
authors.lastname: Amitabh
authors.affiliation: Department of Medical Oncology, Rajiv Gandhi Cancer Institute, Rohini, New Delhi, India.
authors.forename: Prasanta Kumar
authors.initials: PK
authors.lastname: Dash
authors.affiliation: Department of Medical Oncology, Rajiv Gandhi Cancer Institute, Rohini, New Delhi, India.
authors.forename: Jain
authors.initials: J
authors.lastname: Akhil
authors.affiliation: Department of Medical Oncology, Rajiv Gandhi Cancer Institute, Rohini, New Delhi, India.
authors.forename: Mohit
authors.initials: M
authors.lastname: Agarwal
authors.affiliation: Department of Medical Oncology, Rajiv Gandhi Cancer Institute, Rohini, New Delhi, India.
authors.forename: Bajaj
authors.initials: B
authors.lastname: Rajat
keywords: Adenocacinoma lung; pemetrexed; pemetrexed maintenance