[Adjuvant chemotherapy of non-small cell lung cancer: Tolerance of combined cisplatin-pemetrexed therapy]

Rev Mal Respir. 2014 Nov;31(9):817-21. doi: 10.1016/j.rmr.2013.10.646. Epub 2013 Dec 30.
[Article in French]

Abstract

Rationale: Adjuvant chemotherapy is standard for non-small cell lung cancer (NSCLC) after surgical resection. In this context, the tolerance of the treatment is an essential criterion in the choice of chemotherapy. This exploratory study evaluated, in the situation of adjuvant chemotherapy, the tolerance of combined cisplatin-pemetrexed. The study analyzed a cohort of non-squamous NSCLC patients treated in an adjuvant setting by combined cisplatin (75 mg/m(2)) and pemetrexed (500 mg/m(2)), under vitamin B12 and folic acid cover, 4 cycles at 21-day intervals.

Results: The analysis included 23 patients (age: 58.7 ± 5 years, men: 56%, average creatinin clearance (Clea): 94 ± 22 mL/min, average haemoglobin: 13.8 ± 1.6g/dL). Over 92 planned courses, 7.6% are postponed (neutropenia), 4.3% were not given (asthenia). We noted 7 episodes of vomiting (4 grade 3), with two hospitalizations in the same patient; 5 episodes of anaemia grade 1-2 not requiring EPO prescription or transfusion and no febrile neutropenia. At the end of the treatment, three patients had a Clea<50 mL/mn and 5 a haemoglobin between 9 and 11 g/dL.

Conclusion: Combined cisplatin-pemetrexed in an adjuvant situation has a satisfactory tolerance.

Keywords: Adjuvant chemotherapy; Cancer bronchique; Chimiothérapie adjuvante; Cisplatin; Cisplatine; Lung cancer; Pemetrexed; Tolerance; Tolérance.

Publication types

  • English Abstract

MeSH terms

  • Aged
  • Anemia / chemically induced
  • Anemia / epidemiology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Carcinoma, Non-Small-Cell Lung / epidemiology
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Chemotherapy, Adjuvant
  • Cisplatin* / administration & dosage
  • Cisplatin* / adverse effects
  • Female
  • Glutamates* / administration & dosage
  • Glutamates* / adverse effects
  • Guanine / administration & dosage
  • Guanine / adverse effects
  • Guanine / analogs & derivatives*
  • Humans
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / pathology
  • Male
  • Middle Aged
  • Neutropenia / chemically induced
  • Neutropenia / epidemiology
  • Pemetrexed
  • Retrospective Studies

Substances

  • Glutamates
  • Pemetrexed
  • Guanine
  • Cisplatin