NEW YORK (Reuters Health) – As second-line treatment for locally advanced or metastatic non-small-cell lung cancer in Chinese patients, pemetrexed is as effective as docetaxel but with fewer adverse effects, investigators report.
“The current study adds to the clinical evidence for the efficacy and tolerability of second-line, pemetrexed monotherapy in advanced non-squamous NSCLC,” they conclude in their paper in Lung Cancer published online November 19.
Dr. Y. Sun with the Chinese Academy of Medical Sciences in Beijing, and colleagues explain that pemetrexed is approved in several countries as single-agent maintenance therapy for advanced non-squamous NSCLC, based on the results of a 2004 global randomized phase 3 study. However, ethnic variations may affect chemotherapy outcomes, they note.
To meet registration requirements in China, the team randomized 210 Chinese patients with stage IIIB/IV NSCLC to receive pemetrexed or docetaxel every 21 days until disease progression or unacceptable toxicity occurred, or the patient and investigator decided to discontinue.
Median overall survival was not significantly different in the two treatment arms, at 11.7 months with pemetrexed and 12.2 months for docetaxel. This translated to a hazard ratio of 1.14 (p=0.492), according to the report.
On the other hand, there were significantly fewer grade 3-4 adverse events with pemetrexed (20.8%) than with docetaxel (40.2%), the researchers found.
In discussing the results, Dr. Sun and colleagues say the findings are similar to those of the prior global study. However, they point out, overall survival (OS) in the global study was 8.3 months and 7.9 months for the pemetrexed and docetaxel arms, respectively – notably shorter than in the current study of Chinese patients.
“An explanation for the longer OS in the current study,” they suggest, “may be the higher rate of EGFR mutations in Asian versus Western populations.”
