培美曲塞治疗全身化疗和吉非替尼治疗失败的肺腺癌32例临床观察

BACKGROUND AND OBJECTIVE: The relapse-free time of gefitinib as the second or third line therapy in patients with advanced non-small cell lung cancer (NSCLC) was not satisfactory. The aim of this study is to evaluate the efficacy and toxicity of pemetrexed in patients with pulmonary adenocarcinoma after failure to chemotherapy and gefitinib. METHODS: A total of 32 relapsed patients with pulmonary adenocarcinoma after failure to chemotherapy and gefitinib received pemetrexed 500 mg/m(2) by the intravenous administration on the first day, with 21 days as a cycle. Dexamethasone, folic acid and vitamin B(12) were applied to relieve the drug toxicity. The objective response rate was estimated by Response Evaluation Criteria in Solid Tumors (RECIST) and the toxicity was estimated by National Cancer Institute Common Toxicity Criteria (version 3.0). RESULTS: For a total of 32 patients, 4 patients reached partial response (PR), constituting a total of 12.5%; 11 patients reached stable disease (SD), constituting a total of 34.4%; 17 patients reached progressive disease (PD), constituting a total of 53.1%. The median progression free survival (PFS) was 2.7 months. The median overall survival (OS) was 11.0 months. One-year survival rate was 37.5%. The most common adverse events (AEs) were myelosuppression with grade Ⅰ and grade Ⅱ toxicity. Other adverse events were tolerated. CONCLUSION: Pemetrexed was clinically beneficial for the patients with pulmonary adenocarcinoma after the failure of chemotherapy and gefitinib.