| Efficacy of Pemetrexed in Relapsed Non-Small Cell Lung Cancer and Thymidylate Synthase Expression. |
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Choel Kyu Park, Kyu Sik Kim, In Jae Oh, Manaljav Tseden-Ish, Yoo Duk Choi, Yong Soo Kwon, Yoo Il Kim, Sung Chul Lim, Young Chul Kim |
1Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. kyc0923@chonnam.ac.kr
2Department of Pathology, Chonnam National University Medical School, Gwangju, Korea.
3The Brain Korea 21 Project, Center for Biomedical Human Resources at Chonnam National University, Gwangju, Korea. |
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| Abstract |
BACKGROUND
Pemetrexed, a multi-targeted antifolate has been used as a second line treatment against non-small cell lung cancer (NSCLC). We aimed to clarify the efficacy and survival according to line of treatment, histologic type, and expression of thymidylate synthase (TS). METHODS: Ninety-eight patients were treated with pemetrexed as a second line treatment (n=43) or as an additional course of treatment (n=55). TS expression was studied with immunohistochemistry and graded as 0 to 3 based on the extent of expression. RESULTS: The response rate (RR) in 98 subjects was 10.2% and the disease control rate (DCR=PR+SD) was 30.6%. RR and DCR were 12.7% and 32.7% in non-squamous cell carcinoma (NSQC) compared to 7.0% and 27.9% in squamous cell carcinoma (SQC) (p>.05). No significant differences in RR and DCR were observed between a second line group (4.7%, 20.9%) and a further line group (14.5%, 38.2%). A similar trend was observed in the 88 response evaluable subjects. TS was expressed in 28.6% (grade 1), 24.5% (grade 2) and 7.1% (grade 3), respectively, and it was not expressed in 39.8% of subjects. TS expression rate was significantly higher in the SQC (72.1%) compared to NSQC (50.9%, p=0.033). However, the efficacy of pemetrexed was not significantly different by the extent of TS expression. CONCLUSION: Pemetrexed showed efficacy, not only in a second-line setting, but also in further lines of treatment for NSCLC. The efficacy of pemetrexed tended to be higher in patients with NSQC compared to SQC. TS expression rate was significantly higher in SQC compared to NSQC. |
| Key Words:
Non-small-cell lung cancer, Pemetrexed, Thymidylate synthase |
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