Pemetrexed plus Platinum as the First-Line Treatment Option for Advanced Non-Small Cell Lung Cancer: A Meta-Analysis of Randomized Controlled Trials

Li, Ming; Zhang, Qian; Fu, Peifang; Li, Ping; Peng, Aimei; Zhang, Guoliang; Song, Xiaolian; Tong, Min; Li, Xuan; Yang, Liu; Wu, Yueping; Fan, Suyun; Wang, Changhui

doi:10.1371/journal.pone.0037229

Cited by 57 publications

(35 citation statements)

References 24 publications

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“…Non-small cell lung cancer (NSCLC) represents 85% of all lung cancer cases, and most NSCLC patients present with advanced disease with a very poor rate of cure (2,3). Since the 5-year survival of patients with metastatic NSCLC is <15%, prognostic assessment of the patient is essential for the choice of better therapeutic strategies.…”

Section: Introductionmentioning

confidence: 99%

Serum miR-499 as a novel diagnostic and prognostic biomarker in non-small cell lung cancer

Zhang

et al. 2014

Oncology Reports

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Abstract. The aim of the present study was to determine whether serum miR-499 may be used as a biomarker for early detection of non-small cell lung cancer (NSCLC). The present study was designed as an initial screening phase and a subsequent validation phase. In the screening phase, we analyzed serum levels of miR-499 in a subset of 40 patients with stage I (n=20) and stage IV (n=20) NSCLC. In the validation phase, miR-499 expression levels in serum (n=514) and tissue (n=136) from NSCLC patients were detected in a large and independent cohort of 514 patients. miR-499 in the screening phase was found to be significantly elevated in the serum of stage I NSCLC patients compared with that in stage IV NSCLC patients (P<0.001). Validation analysis showed that serum miR-499 levels were robust in differentiating NSCLC patients from control subjects [area under the curve (AUC)=0.906; 95% confidence interval (CI)=0.879 to 0.929). Serum miR-499 levels were significantly lower in stage III and IV patients compared with those with stage I (both P<0.001) or II (both P<0.001). Low serum miR-499 levels were associated with shorter overall survival and served as an independent prognostic biomarker in NSCLC patients [hazard ratio (HR)=1.63; 95% CI=1.33-2.0; P<0.0001). In addition, low serum levels of miR-499 indicated a poor disease-free survival in stage I-II NSCLC patients. Serum miR-499 may prove to be a promising biomarker for early detection and prognosis prediction of NSCLC.

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Section: Introductionmentioning

confidence: 99%

Serum miR-499 as a novel diagnostic and prognostic biomarker in non-small cell lung cancer

Zhang

et al. 2014

Oncology Reports

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“…Recently gemcitabine, with platinum chemotherapy [5]. Even though globally they concluded that the combination of pemetrexed and platinum derivatives was associated to longer OS (HR = 0.91 95% CI: 0.83-1.00), this study should be taken cautiously.…”

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confidence: 77%

Take-home message in times of crisis: Is it really better to treat with cisplatin & pemetrexed than cisplatin & gemcitabine in first line NSCLC? The power of statistical considerations

Rolfo

Castañón

2015

Lung Cancer

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“…These findings raise the possibility that two drugs can and should be used in some groups of older cancer patients in the hope of garnering a survival advantage for them. In nonsquamous cancer patients the combination of pemetrexed and carboplatinum appears to be well tolerated and effective [26]. A subset analysis of a clinical trial comparing carboplatin/pemetrexed to carboplatin/docetaxel showed a favorable toxicity profile for the carboplatin/pemetrexed combination in the elderly subset [27].…”

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confidence: 99%

Non-Small-Cell Lung Cancer in the Elderly With An Emphasis On Chemotherapy In The Adjuvant And Metastatic Disease Settings

Menon

Jatoi

2014

Lung Cancer Manag.

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SUMMARY Most lung cancer patients in the USA are older than 65 years of age, and yet oncologists continue to struggle with how best to treat these older patients. This article reviews the medical management of non-small-cell lung cancer in older patients with a focus on decision-making with respect to chemotherapy in the adjuvant setting and metastatic disease settings. In these two settings, chemotherapy as a single-modality intervention can provide a major positive impact. Nonetheless, a relative dearth of evidence in these settings underscores the need to summarize the available data in an effort to make patient counseling easier for healthcare providers and to make decision-making easier for patients and their families.Lung cancer is a disease of the elderly. Previous studies show that 47% of lung cancer patients are 70 years of age or older [1]. In this setting, decreased organ function with reduced clearance of chemotherapy and poor bone marrow reserve can cause high rates of severe adverse events. For example, myelosuppression is a frequently reported adverse event in older cancer patients, and it can be severe. Thus, older patients, who represent a substantial proportion of all lung cancer patients, often require greater time and effort in the clinic, as oncology healthcare providers advise these patients about the role of chemotherapy in the management of their disease.A major challenge medical oncologists face is determining whether or not to prescribe chemotherapy to older cancer patients, and, if so, how. Enrollment of older patients to cancer clinical trials has been comparatively limited [2], thus raising concerns that conclusions from such trials may not Practice points• A large proportion of lung cancer patients are 70 years of age or older.• The limited participation of elderly patients in prospective clinical trials lessens our ability to make robust conclusions.• There is a need for better tools for comprehensive assessments in older patients in order to better predict how well they will tolerate chemotherapy.• Subset analyses suggest some older patients may benefit from adjuvant chemotherapy. However, there is sparse evidence to support adjuvant chemotherapy in patients who are 80 years of age or older.• In patients with metastatic lung cancer, evidence supports that chemotherapy can prolong life and improve symptoms.• Combination chemotherapy may be feasible in a subset of older non-small-cell lung cancer patients.• There is controversy regarding the benefit of bevacizumab in older non-small-cell lung cancer patients.For reprint orders, please contact: reprints@futuremedicine.com

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Pemetrexed plus Platinum as the First-Line Treatment Option for Advanced Non-Small Cell Lung Cancer: A Meta-Analysis of Randomized Controlled Trials

Cited by 57 publications

References 24 publications

Serum miR-499 as a novel diagnostic and prognostic biomarker in non-small cell lung cancer

Serum miR-499 as a novel diagnostic and prognostic biomarker in non-small cell lung cancer

Take-home message in times of crisis: Is it really better to treat with cisplatin & pemetrexed than cisplatin & gemcitabine in first line NSCLC? The power of statistical considerations

Non-Small-Cell Lung Cancer in the Elderly With An Emphasis On Chemotherapy In The Adjuvant And Metastatic Disease Settings

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