A prospective phase II study: high-dose pemetrexed as second-line chemotherapy in small-cell lung cancer

Bjørn H Grønberg*, Roy M Bremnes, Ulf Aasebø, Paal Brunsvig, Oystein Fløtten, Tore Amundsen, Christian von Plessen, Mari Wang, Stein Sundstrøm, Norwegian Lung Cancer Study Group


Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review


PURPOSE: To investigate the efficacy and tolerability of high-dose pemetrexed as second-line chemotherapy in small cell lung cancer (SCLC).

PATIENTS AND METHODS: Patients with verified SCLC who had received one prior chemotherapy regimen, aged 18-75 years, WHO Performance Status 0-2, no clinical signs of brain metastases and measurable disease were eligible. Patients received pemetrexed 900 mg/m(2) IV every 3 weeks. Four courses were planned for all patients. Patients with relapse later than 3 months since last course of first-line chemotherapy were defined as "sensitive", those with relapse within 3 months as "refractory". Toxicity was graded using the CTCAE v3.0.

RESULTS: 36 patients were accrued, 34 received study treatment. Median age was 61 (range 43-74), 18 (53%) males and 16 (47%) females. Mean number of courses administered was 2.5. One patient (3%) had partial response, three (9%) had stable disease and 29 (85%) progressed. One patient (3%) was not evaluable for response. Median TTP (n=33) was 7.7 weeks ("sensitive": 8.4 weeks, "refractory": 5.1 weeks). Median OS (n=34) was 17.6 weeks ("sensitive": 22.6 weeks, "refractory": 15.3 weeks). Of grade 3-4 haematological toxicity, anemia was observed in 2 (6%) patients, leukopenia in 6 (18%), granulocytopenia in 9 (27%) and thrombocytopenia in 3 (9%). Febrile neutropenia occurred in 6 (18%) patients. There were no treatment related deaths.

CONCLUSION: High-dose pemetrexed monotherapy to patients with recurrent SCLC yielded moderate toxicity, but limited treatment efficacy.

TidsskriftLung cancer (Amsterdam, Netherlands)
Udgave nummer1
Sider (fra-til)88-93
StatusUdgivet - jan. 2009
Udgivet eksterntJa


  • Adult
  • Aged
  • Antimetabolites, Antineoplastic
  • Disease Progression
  • Female
  • Glutamates
  • Guanine
  • Humans
  • Lung Neoplasms
  • Male
  • Middle Aged
  • Prospective Studies
  • Recurrence
  • Small Cell Lung Carcinoma
  • Time Factors
  • Treatment Outcome


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