Phase i study of 'dose-dense' pemetrexed plus carboplatin/radiotherapy for locally advanced non-small cell lung carcinoma.

Authors

Xinglei Shen, Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson UniversityFollow
Albert Denittis, Department of Radiation Oncology, Lankenau Hospital and Lankenau Institute for Medical Research, Main Line Health SystemFollow
Maria Werner-Wasik, Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson UniversityFollow
Rita Axelrod, Department of Medical Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson UniversityFollow
Paul Gilman, Department of Hematology/Oncology, Lankenau Hospital and Lankenau Institute for Medical Research, Main Line Health System
Thomas Meyer, Department of Hematology/Oncology, Lankenau Hospital and Lankenau Institute for Medical Research, Main Line Health System
Joseph Treat, Eli Lilly, Inc.
Walter J Curran, Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University; Department of Radiation Oncology, Emory University HospitalFollow
Mitchell Machtay, Department of Radiation Oncology, Kimmel Cancer Center, Jefferson Medical College of Thomas Jefferson University; Department of Radiation Oncology, University Hospitals, Case Medical CenterFollow

Document Type

Article

Publication Date

2-16-2011

Comments

This article has been peer reviewed and is published in Radiation Oncology 2011, 6:17. The published version is available at DOI: 10.1186/1748-717X-6-17. ©BioMed Central Ltd.

Abstract

BACKGROUND: This phase I study investigates the feasibility of carboplatin plus dose-dense (q2-week) pemetrexed given concurrently with radiotherapy (XRT) for locally advanced and oligometastatic non-small cell lung cancer (NSCLC).

METHODS: Eligible patients had Stage III or IV (oligometastatic) NSCLC. Patients received XRT to 63 Gy in standard fractionation. Patients received concurrent carboplatin (AUC = 6) during weeks 1 and 5 of XRT, and pemetrexed during weeks 1, 3, 5, and 7 of XRT. The starting dose level (level 1) of pemetrexed was 300 mg/m2. Following the finding of dose limiting toxicity (DLT) in dose level 1, an amended dose level (level 1A) continued pemetrexed at 300 mg/m2, but with involved field radiation instead of extended nodal irradiation. Consolidation consisted of carboplatin (AUC = 6) and pemetrexed (500 mg/m2) q3 weeks × 2 -3 cycles.

RESULTS: Eighteen patients were enrolled. Fourteen patients are evaluable for toxicity analysis. Of the initial 6 patients treated on dose level 1, two experienced DLTs (one grade 4 sepsis, one prolonged grade 3 esophagitis). There was one DLT (grade 5 pneumonitis) in the 8 patients treated on dose level 1A. In 16 patients evaluable for response (4 with oligometastatic stage IV disease and 12 with stage III disease), the median follow-up time is 17.8 months. Thirteen of 16 patients had in field local regional response. The actuarial median survival time was 28.6 months in all patients and 34.7 months (estimated) in stage III patients.

CONCLUSIONS: Concurrent carboplatin with dose-dense (q2week) pemetrexed at 300 mg/m2 with involved field XRT is feasible and encouraging in patients with locally advanced and oligometastatic NSCLC.

Recommended Citation

Shen, Xinglei; Denittis, Albert; Werner-Wasik, Maria; Axelrod, Rita; Gilman, Paul; Meyer, Thomas; Treat, Joseph; Curran, Walter J; and Machtay, Mitchell, "Phase i study of 'dose-dense' pemetrexed plus carboplatin/radiotherapy for locally advanced non-small cell lung carcinoma." (2011). Department of Radiation Oncology Faculty Papers. Paper 19.
https://jdc.jefferson.edu/radoncfp/19

PubMed ID

21324160