Another study comparing pemetrexed with pemetrexed plus carboplatin in patients experiencing relapse after platinum-based chemotherapy showed that adding carboplatin
to second-line pemetrexed treatment significantly increases ORR and PFS in patients with NSCLC after having received first-line platinum-based chemotherapy . This conclusion is consistent with our results. However, the patients in the latter study did not receive a longer OS for pemetrexed combined with carboplatin chemotherapy compared with pemetrexed single agent chemotherapy, www.selleckchem.com/products/c188-9.html which may be associated with the application of different platinum. In our study, 21 patients (40% of all patients enrolled) received pemetrexed/carboplatin chemotherapy, while the remaining 32 patients (60% of all patients enrolled) received pemetrexed/cisplatin chemotherapy. All of the patients received pemetrexed/carboplatin chemotherapy in the latter study.
In addition, racial differences may also be a factor. Our data came PARP assay from the Chinese people, and their data came from non-Asians. In short, the study showed, locally advanced or metastatic NSCLC patients previously treated with platinum-based chemotherapy could benefit from pemetrexed plus cisplatin/carboplatin chemotherapy with tolerable adverse events. For patients with advanced or metastatic cancer, the quality of life is important. In our study, we found some patients’ quality of life was obviously increased even though their tumor was stable or progressive after chemotherapy. Due to a minor flaw in the original study design, there are no available data on whether patients’ qualities
of life were increased or not. Pemetrexed produces its cytotoxic effect by blocking intracellular thymidylate synthase, dihydrofolate reductase, and glycinamide ribonucleotide formyl transferase. A deeper knowledge of those target enzymes may be used in the future to identify patients’ responses to pemetrexed . The targeted compounds combined with chemotherapy regimens might represent the next step treatment of not NSCLC and the characteristics of pemetrexed make it a candidate in therapies context. This study reported clinical DMXAA experience with pemetrexed plus platinum for previously treated patients with locally advanced or metastatic non-small cell lung cancer and further prospective randomized clinical trials will confirm whether pemetrexed combined with platinum is a valid option for pretreated locally advanced or metastatic NSCLC patients. Acknowledgements We wish to thank Li-Xin Xie for his guidance in the writing of this manuscript. We are also grateful to medical personnel of Department of Oncology Medicine and Department of Respiratory Medicine of Chinese PLA General Hospital, which treated the patients in this study. References 1. Ho C, Davies AM, Lara PN Jr, Gandara DR: Second-line treatment for advanced-stage non-small celllung cancer: current and future options. clin lung cancer 2006,7(Supple 4):S118–125.