Experience of pemetrexed in maintenance therapy for metastatic lung adenocarcinoma

Lung cancer is among the most common malignant diseases in Russia. In 80–90%, its morphological type is nonsmall cell lung cancer. Stage IV primary advanced lung cancer is diagnosed in 41% of patients. Median overall survival in stage IV patients receiving chemotherapy is 7–12 months. Treatment for...

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Main Authors: L. Yu. Vladimirova, A. E. Storozhakova, E. A. Kalabanova, P. N. Meshcheryakov, S. V. Oskin, S. N. Kabanov, N. Yu. Samaneva, Ya. V. Svetitskaya, A. V. Tishina
Format: Article
Language:Russian
Published: ANO "Perspective of oncology" 2021-03-01
Series:Южно-Российский онкологический журнал
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Online Access:https://www.cancersp.com/jour/article/view/105
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author L. Yu. Vladimirova
A. E. Storozhakova
E. A. Kalabanova
P. N. Meshcheryakov
S. V. Oskin
S. N. Kabanov
N. Yu. Samaneva
Ya. V. Svetitskaya
A. V. Tishina
author_facet L. Yu. Vladimirova
A. E. Storozhakova
E. A. Kalabanova
P. N. Meshcheryakov
S. V. Oskin
S. N. Kabanov
N. Yu. Samaneva
Ya. V. Svetitskaya
A. V. Tishina
author_sort L. Yu. Vladimirova
collection DOAJ
description Lung cancer is among the most common malignant diseases in Russia. In 80–90%, its morphological type is nonsmall cell lung cancer. Stage IV primary advanced lung cancer is diagnosed in 41% of patients. Median overall survival in stage IV patients receiving chemotherapy is 7–12 months. Treatment for stage IV lung adenocarcinoma is based on predictive and prognostic factors. Chemotherapy, chemoimmunotherapy or immunotherapy is recommended in the absence of driver mutations in the EGFR (exons 19 and 21) and BRAF genes, ALK and ROS1 translocations.Platinum- based regimens are preferred as the fi rst-line chemotherapy. Stabilization, partial or complete response after 4–6 chemotherapy cycles allow for maintenance therapy with pemetrexed to increase progression-free survival and overall survival.Purpose of the study. Using a real clinical case, to confirm the efficacy of pemetrexed in the treatment for stage IV lung adenocarcinoma in the second-line therapy in combination with platinum- based agents and in a maintenance therapy.A clinical case of a patient with central cancer of the lower lobe of the right lung St IV (cT3N2M1) is presented; the first treatment stage involved 3 cycles of the fi rst-line polychemotherapy (paclitaxel 175 mg/m² intravenously on day 1, carboplatin AUC 5 intravenously on day 1, every 3 weeks), and 6 cycles of the second-line polychemotherapy (pemetrexed 500 mg/m2 intravenously on day 1, cisplatin 75 mg/m² intravenously on day 1 of the 21-day cycle). Stabilization of the disease was achieves, and 20 cycles of maintenance therapy with pemetrexed followed; the achieved effect persisted and was confirmed by spiral X-ray computed tomography every 3 months. The objective effect of anticancer therapy was assessed according to the RECIST 1.1 criteria. It took 20 months from the beginning of the second-line anticancer medical therapy to progression, and 16 months from the start of maintenance pemetrexed to progression. The safety profile was satisfactory, and the ECOG performance status 0 maintained. Only one adverse effect, degree I general weakness, was noted, which did not have a negative impact on the patient's quality of life.
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publisher ANO "Perspective of oncology"
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spelling doaj-art-076418e5fa3841ad91f9a0ffc47fbf9e2025-08-20T03:42:06ZrusANO "Perspective of oncology"Южно-Российский онкологический журнал2686-90392021-03-0121354210.37748/2686-9039-2021-2-1-432Experience of pemetrexed in maintenance therapy for metastatic lung adenocarcinomaL. Yu. Vladimirova0A. E. Storozhakova1E. A. Kalabanova2P. N. Meshcheryakov3S. V. Oskin4S. N. Kabanov5N. Yu. Samaneva6Ya. V. Svetitskaya7A. V. Tishina8National Medical Research Centre for Oncology of the Ministry of Health of RussiaNational Medical Research Centre for Oncology of the Ministry of Health of RussiaNational Medical Research Centre for Oncology of the Ministry of Health of RussiaNational Medical Research Centre for Oncology of the Ministry of Health of RussiaNational Medical Research Centre for Oncology of the Ministry of Health of RussiaNational Medical Research Centre for Oncology of the Ministry of Health of RussiaNational Medical Research Centre for Oncology of the Ministry of Health of RussiaNational Medical Research Centre for Oncology of the Ministry of Health of RussiaNational Medical Research Centre for Oncology of the Ministry of Health of RussiaLung cancer is among the most common malignant diseases in Russia. In 80–90%, its morphological type is nonsmall cell lung cancer. Stage IV primary advanced lung cancer is diagnosed in 41% of patients. Median overall survival in stage IV patients receiving chemotherapy is 7–12 months. Treatment for stage IV lung adenocarcinoma is based on predictive and prognostic factors. Chemotherapy, chemoimmunotherapy or immunotherapy is recommended in the absence of driver mutations in the EGFR (exons 19 and 21) and BRAF genes, ALK and ROS1 translocations.Platinum- based regimens are preferred as the fi rst-line chemotherapy. Stabilization, partial or complete response after 4–6 chemotherapy cycles allow for maintenance therapy with pemetrexed to increase progression-free survival and overall survival.Purpose of the study. Using a real clinical case, to confirm the efficacy of pemetrexed in the treatment for stage IV lung adenocarcinoma in the second-line therapy in combination with platinum- based agents and in a maintenance therapy.A clinical case of a patient with central cancer of the lower lobe of the right lung St IV (cT3N2M1) is presented; the first treatment stage involved 3 cycles of the fi rst-line polychemotherapy (paclitaxel 175 mg/m² intravenously on day 1, carboplatin AUC 5 intravenously on day 1, every 3 weeks), and 6 cycles of the second-line polychemotherapy (pemetrexed 500 mg/m2 intravenously on day 1, cisplatin 75 mg/m² intravenously on day 1 of the 21-day cycle). Stabilization of the disease was achieves, and 20 cycles of maintenance therapy with pemetrexed followed; the achieved effect persisted and was confirmed by spiral X-ray computed tomography every 3 months. The objective effect of anticancer therapy was assessed according to the RECIST 1.1 criteria. It took 20 months from the beginning of the second-line anticancer medical therapy to progression, and 16 months from the start of maintenance pemetrexed to progression. The safety profile was satisfactory, and the ECOG performance status 0 maintained. Only one adverse effect, degree I general weakness, was noted, which did not have a negative impact on the patient's quality of life.https://www.cancersp.com/jour/article/view/105non-small cell lung canceradenocarcinomapemetrexedmaintenance therapyadverse effectsdisease stabilization
spellingShingle L. Yu. Vladimirova
A. E. Storozhakova
E. A. Kalabanova
P. N. Meshcheryakov
S. V. Oskin
S. N. Kabanov
N. Yu. Samaneva
Ya. V. Svetitskaya
A. V. Tishina
Experience of pemetrexed in maintenance therapy for metastatic lung adenocarcinoma
Южно-Российский онкологический журнал
non-small cell lung cancer
adenocarcinoma
pemetrexed
maintenance therapy
adverse effects
disease stabilization
title Experience of pemetrexed in maintenance therapy for metastatic lung adenocarcinoma
title_full Experience of pemetrexed in maintenance therapy for metastatic lung adenocarcinoma
title_fullStr Experience of pemetrexed in maintenance therapy for metastatic lung adenocarcinoma
title_full_unstemmed Experience of pemetrexed in maintenance therapy for metastatic lung adenocarcinoma
title_short Experience of pemetrexed in maintenance therapy for metastatic lung adenocarcinoma
title_sort experience of pemetrexed in maintenance therapy for metastatic lung adenocarcinoma
topic non-small cell lung cancer
adenocarcinoma
pemetrexed
maintenance therapy
adverse effects
disease stabilization
url https://www.cancersp.com/jour/article/view/105
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AT aestorozhakova experienceofpemetrexedinmaintenancetherapyformetastaticlungadenocarcinoma
AT eakalabanova experienceofpemetrexedinmaintenancetherapyformetastaticlungadenocarcinoma
AT pnmeshcheryakov experienceofpemetrexedinmaintenancetherapyformetastaticlungadenocarcinoma
AT svoskin experienceofpemetrexedinmaintenancetherapyformetastaticlungadenocarcinoma
AT snkabanov experienceofpemetrexedinmaintenancetherapyformetastaticlungadenocarcinoma
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