129P - Effectiveness of first-line pemetrexed plus platinum for advanced nonsquamous non-small cell lung cancer

Date 17 April 2015
Event ELCC 2015
Session Poster lunch
Topics Anti-Cancer Agents & Biologic Therapy
Non-Small-Cell Lung Cancer, Metastatic
Presenter Mariana Brandão
Citation Annals of Oncology (2015) 26 (suppl_1): 29-44. 10.1093/annonc/mdv050
Authors M.D.R.A. Brandão, M.S. Luis, N.C. Amaral, M. Cassiano Neves, C. Camacho, A.C. Rodrigues, I. Pousa, J. Oliveira, I. Azevedo, M.A. Soares
  • Medical Oncology, Instituto Portugues de Oncologia Centro do Porto(IPO-Porto), 4200-072 PORTO - Porto/PT



Since 2010 that the combination of platinum / pemetrexed is approved as first line therapy for advanced (locally advanced or metastatic) nonsquamous non-small cell lung cancer (NSCLC). Our aim is to assess the effectiveness of first-line pemetrexed plus platinum for advanced nonsquamous NSCLC in clinical practice.


Consecutive series of patients with advanced nonsquamous NSCLC treated with pemetrexed plus platinum as first-line therapy, at our center, from May 2010 to July 2013. The date of data cutoff was December 12, 2014. Data on demographics, prognostic factors, response, survival and toxicity were retrieved from clinical files.


193 patients were included. Baseline characteristics: median age 64 years (range 34-81); 71% males; 97% adenocarcinoma; 29% never smokers; 26% ECOG performance status (PS) 0, 65% PS 1 and 9% PS 2 or 3; 81% stage IV; 8% received prior therapies with curative intent. The median number of cycles was 6 (range 1–6). 74% received cisplatin plus pemetrexed and the remaining 26% carboplatin plus pemetrexed. One patient had complete response and 14% presented a partial response. Median follow-up time for patients alive at last follow up was 38 months. Median overall survival (OS) was 10 months (95% CI 8.0–12.0), progression-free survival (PFS) was 5 months (95% CI 4.3–5.7) and 12 month survival rate was 45% (95% CI 38.0–52.0). Patients on carboplatin plus pemetrexed had an OS of 13 months (95% CI 8.7–17.3), a PFS of 5 months (95% CI 3.5–6.5) and a 12 month survival rate of 53% (95% CI 39.3–66.7). 45% of patients underwent a second-line therapy and 16% received two or more therapy lines after pemetrexed plus platinum. Male sex, a PS ≥ 1 and absence of prior therapies with curative intent were predictors of a poorer prognosis. Grade 3–4 toxicity was identified only in 18% of patients: hematological (6%) and respiratory infection (5%); 10% of patients were hospitalized for reasons related to therapy.


As expected, the OS was lower than what was observed in the clinical trial setting; however, the PFS was similar. The platinum plus pemetrexed combination was well tolerated by patients, with a low hospitalization rate.


All authors have declared no conflicts of interest.