Pemetrexed as Second-Line Treatment in Malignant Pleural Mesothelioma after Platinum-Based First-Line Treatment
Pemetrexed as Second-Line Treatment in Malignant Pleural Mesothelioma after Platinum-Based First-Line Treatment
复制标题
培美曲塞作为铂类一线治疗后恶性胸膜间皮瘤的二线治疗
DOI：
10.1097/jto.0b013e31802f3813
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发表时间：
2007
影响因子：
20.4
通讯作者：
A. Thielsen
中科院分区：
文献类型：
--
作者：
J. Sørensen;S. Sundstrøm;Katharina Perell;A. Thielsen
前言：培美曲塞是治疗恶性胸膜间皮瘤的有效一线药物。目的是评估其作为二线治疗的活性。方法：对恶性胸膜间皮瘤患者在以往未用培美曲塞的铂类药物治疗后病情进展情况进行分析。单用培美曲塞或培美曲塞联合卡铂治疗。培美曲塞剂量为500 mg/m2，卡铂为AUC(曲线下面积)，每3周1次。结果：纳入39名患者：28名丹麦患者接受培美曲塞治疗(3名患者接受培美曲塞作为三线治疗)，而11名挪威患者接受培美曲塞加卡铂治疗。大多数患者是男性(90%)，有上皮亚型(85%)，国际间皮瘤兴趣组第三至第四期(77%)。中位年龄62岁(30-77岁)。治疗疗程的中位数为6个(1-23个)。常见的毒性标准3-4级毒性仅发生在白细胞减少症(培美曲塞：14%；培美曲塞+卡铂：9%)和血小板减少症(培美曲塞：7%；培美曲塞+卡铂：18%)方面。1例接受培美曲塞治疗的患者死于败血症。部分缓解率分别为21%和18%，中位进展时间分别为21周(4~92周)和32周(4~128+)，中位生存期分别为42周(4~99周)和39周(10~128+)。结论：培美曲塞在恶性胸膜间皮瘤中耐受性良好，在之前的铂类药物治疗后有显著的活性，可考虑作为二线治疗。
Introduction: Pemetrexed is active as first-line treatment of malignant pleural mesothelioma. The objective was to evaluate its activity as second-line treatment. Methods: Patients had disease progression of malignant pleural mesothelioma after previous platinum-based regimens without pemetrexed. Treatment was pemetrexed alone or pemetrexed combined with carboplatin. Pemetrexed dosing was 500 mg/m2 and carboplatin was AUC (area under the curve) 5 once every 3 weeks. Results: Thirty-nine patients were included: 28 Danish patients received pemetrexed (three patients received pemetrexed as third-line treatment), whereas 11 Norwegian patients received pemetrexed plus carboplatin. Most patients were men (90%), had epithelial subtype (85%), and International Mesothelioma Interest Group stages III to IV (77%). Median age was 62 years (range, 30–77). The median number of treatment courses was six (range, 1–23). Common Toxicity Criteria grade 3 to 4 toxicity occurred only with respect to leukocytopenia (pemetrexed: 14% of patients; pemetrexed plus carboplatin: 9%) and thrombocytopenia (pemetrexed: 7%; pemetrexed plus carboplatin: 18%). One patient receiving pemetrexed died of sepsis. Partial response rates were 21% and 18%, the median time to progression was 21 weeks (range, 4–92) and 32 weeks (range, 4–128+), and the median survival was 42 weeks (range, 4–99) and 39 weeks (range, 10–128+) with pemetrexed and pemetrexed plus carboplatin, respectively. Conclusions: Pemetrexed was generally well tolerated with noteworthy activity in malignant pleural mesothelioma after previous platinum-based treatment and may be considered for second-line treatment.