Does maintenance pemetrexed maintain quality of life?

摘要

In 2009, Tudor Ciuleanu and colleagues presented the efficacy results of the JMEN phase 3 trial1 that compared maintenance pemetrexedto placebo in patients with non-smail-cell lung cancer (NSCLC) who had radiographical evidence of stable disease or a response after four cycles of doublet platinum-based therapy that did not contain pemetrexed. In the intent-to-treat population, maintenance pemetrexed improved progression-free survival and overall survival, but the benefit was restricted to patients with non-squamous histology. The only physician-reported toxic effects of grade 3 or grade 4 that occurred at a significantly higher rate in the pemetrexed compared with the placebo group were neutropenia (3% vs 0%) and fatigue (5% vs <1%). The rate of fatigue (ail grades) in the pemetrexed and placebo groups was 24% and 10%, respectively. This trial established a new treatment option for some patients with advanced NSCLC. However, this treatment strategy commits patients to continuous cytotoxic chemotherapy in a disease setting in which the overall survival benefit remains modest.