Prospective Analysis of Patients Treated with Chemotherapy in Metastatic Adenocarcinoma of Lung—Single Centre Experience

Abstract

Background: Lung cancer is the leading cause of cancer-related death worldwide with an estimated 1.6 million new cases diagnosed each year. According to standard guidelines in NSCLC, the effectiveness of combin ed chemotherapy regimen comprises of pemetrexed and platinum, and very few reports are available in Indian population. This study shows the experience with pemetrexed and platinum combination chemotherapy in metastatic NSCLC in first line setting. Methods: Total 61 patients with following inclusion criteria were recruited such as : 1) PS of 1 and 2 ; 2) NSCLC of non-squamous histology ; 3) locally advanced or metastatic disease at diagnosis ; 4) should have received minimum 3 cycles of pemetrexed and platinum as first line treatment and or continued for 6 cycles ; 5) EGFR/ALK mutated or EGFR/ALK unknown patients but must have received upfront chemo. Primary endpoint of the present study is to assess Disease Control Rate (DCR) (CR + PR + SD). Progression Free Survival, OS and Toxicity assessment were secondary endpoints. Results: The mean number of average chemotherapy cycles was found to be 4.38. The range of chemotherapy was 2 - 6 cycles. Disease control rate, defined as (CR + PR + SD), was seen in 44 (72.1%) patients. (PR in 26 (42.62%), SD 18 (29.5%)), Progressive disease (PD) was observed in 17 (27.9%) patients. Over all study showed that patients had PFS of 9.414 months (95% CI 6.709 - 12.120) and OS of 13.437 months (95% CI 10.721 - 16.153). Conclusion: Pemetrexed and platinum combination is effective and well-tolerated chemotherapy regi men in patients with metastatic adenocarcinoma lung cancer patients. Pemetrexed and cisplatin may be more effective in particular. Early switch over to TKIs is preferred immediately after obtaining molecular subtype result.