title: Single pemetrexed is noninferior to platinum-based pemetrexed doublet as first-line treatment on elderly Chinese patients with advanced nonsquamous nonsmall cell lung cancer.
abstract: BACKGROUND
  To evaluate the clinical efficacy and toxicity of single pemetrexed treatment compared with platinum-based pemetrexed doublet pemetrexed-based as first-line treatment for advanced nonsquamous nonsmall cell lung cancer (NS-NSCLC) in elderly Chinese patients.
  
  
  METHODS
  The study retrospectively reviewed 175 elderly Chinese patients with NS-NSCLC from June 2010 to September 2013: 90 patients received single pemetrexed treatment, 45 received pemetrexed plus oxaliplatin, and 40 received pemetrexed plus carboplatin. Clinical efficacy was assessed using disease control rate (DCR), overall survival (OS), and progression-free survival (PFS).
  
  
  RESULTS
  DCR, OS, and PFS did not significantly differ between single pemetrexed treatment (OS: 14.9 months; DCR: 62.2%; PFS: 3.3 months), pemetrexed plus oxaliplatin (OS: 16.5 months; DCR: 71.1%; PFS: 4.5 months), and pemetrexed plus carboplatin (OS: 15.5 months; DCR: 70.0%; PFS: 4.6 months) groups. Pemetrexed treatment caused significantly lower incidences of adverse events, such as hepatotoxicity and peripheral nerve injury. Performance status (PS), TNM stage, and Thymidylate synthase (TS) expression were predictive factors of DCR. Pemetrexed chemotherapy cycles, PS, and TNM stage were independent prognostic factors.
  
  
  CONCLUSIONS
  Single pemetrexed was noninferior to platinum-based pemetrexed doublet for clinical efficacy and safety in elderly Chinese patients with advanced NS-NSCLC. Chemotherapy cycles, performance status, and TNM stage were independent prognostic factors.
authors.affiliation: Department of Oncology, Changzhou No. 2 People's Hospital, the Affiliated Hospital of Nanjing Medical University, Changzhou Department of Oncology, Department of Clinical Epidemiology, Jiangsu Province Geriatric Institute Department of Oncology, The First Affiliated Hospital of Nanjing Medical University Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University Department of Oncology, Jiangsu Province Geriatric Institute Central Laboratory, Jiangsu Province Geriatric Institute, Nanjing, China.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Pu
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Binbin
authors.initials: B
authors.lastname: Lu
authors.forename: Zhaoxia
authors.initials: Z
authors.lastname: Wang
authors.forename: Min
authors.initials: M
authors.lastname: Yang
authors.forename: Weifei
authors.initials: W
authors.lastname: Fan
authors.forename: Lijuan
authors.initials: L
authors.lastname: Meng
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Lv
authors.forename: Yuchun
authors.initials: Y
authors.lastname: Xie
authors.forename: Jun
authors.initials: J
authors.lastname: Wang
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use; D018287:Carcinoma, Large Cell / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D015999:Multivariate Analysis; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D000068437:Pemetrexed / Q000627:therapeutic use*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; D000068437:Pemetrexed; D000077150:Oxaliplatin; D016190:Carboplatin