- Volume 15 Issue 8
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Effectiveness and Safety of Pemetrexed Versus Docetaxel as a Treatment for Advanced Non-small Cell Lung Cancer: a Systematic Review and Meta-analysis
- Di, Bao-Shan (The First Clinical Medical School of Lanzhou University) ;
- Wei, Kong-Ping (Department of Pediatrics, the Second Hospital of Lanzhou University) ;
- Tian, Jin-Hui (Evidence Based Medicine Center of Lanzhou University) ;
- Xiao, Xiao-Juan (Department of Radiology, The First Affiliated Hospital, Sun Yat-sen University) ;
- Li, Yan (Department of Computer Science, Gansu Institute of Political Science and Law) ;
- Zhang, Xu-Hui (Department of Geratology, The Affiliated Hospital of Gansu College of Traditional Chinese Medicine Lanzhou) ;
- Yu, Qin (The First Clinical Medical School of Lanzhou University) ;
- Yang, Ke-Hu (Evidence Based Medicine Center of Lanzhou University) ;
- Ge, Long (Evidence Based Medicine Center of Lanzhou University) ;
- Huang, Wen-Hui (Department of Nephrology, Gansu Provincial Hospital) ;
- Zhang, Fang-Wa (Evidence Based Medicine Center of Lanzhou University)
- Published : 2014.04.30
Background: Our aim was to conduct a meta-analysis to compare the efficacy and safety of pemetrexed and docetaxel for non-small cell lung cancer (NSCLC). Materials and Methods: We systematically searched the Cochrane Library, PubMed, Embase, China Biology Medicine Database for randomized controlled trials (RCTs) comparing the efficacy and toxicities of pemetrexed versus docetaxel as a treatment for advanced NSCLC. We limited the languages to English and Chinese. Two reviewers independently screened articles to identify eligible trials according to the inclusion and exclusion criteria and assessed the methodological quality of included trials, and then extracted data. The meta-analysis was performed using STATA12.0. Results: Six RCTs involving 1,414 patients were identified. We found that there was no statistically significant differences in overall response rate, survival time, progression-free survival, disease control rate, and 1-2yr survival rate (p>0.050) but it is worthy of mention that patients in the pemetrexed arms had significantly higher 3-yr survival rate (P=0.002). With regard to the grade 3 or 4 hematological toxicity, compared with docetaxel, pemetrexed led to lower rate of grade 3-4 febrile neutropenia, neutropenia, and leukocyts toxicity (p<0.001). There was no significant difference in anemia between the two arms (p=0.08). In addition, pemetrexed led to higher rate of grade 3-4 thrombocytopenia toxicity (p=0.03). As for the non-hematological toxicities, compared with docetaxel, pemetrexed group had lower rate of grade 3-4 diarrhea and alopecia. Conclusions: Pemetrexed was almost as effective as docetaxel in patients with advanced NSCLC. At the same time, pemetrexed might increase the 3-yr survival rate. As for safety, pemetrexed led to lower rate of grade 3-4 febrile neutropenia, neutropenia, leukocytes, diarrhea and alopecia toxicity. However, it was associated with a higher rate of grade 3-4 thrombocytopenia.
- Rodrigues-Pereira J, Kim J H, Magallanes M, et al (2011). A randomized phase 3 trial comparing pemetrexed/carboplatin and docetaxel/carboplatin as first-line treatment for advanced, nonsquamous non-small cell lung cancer. J Thorac Oncol, 6, 1907-14. https://doi.org/10.1097/JTO.0b013e318226b5fa
- Sun Y, Wu YL, Zhou CC, et al (2013). Second-line pemetrexed versus docetaxel in Chinese patients with locally advanced or metastatic non-small cell lung cancer: A randomized, open-label study. Lung Cancer, 79, 143-50. https://doi.org/10.1016/j.lungcan.2012.10.015
- Zhang X, Qin Y, Li H, et al (2011). Efficacy and safety of vandetanib, a dual VEGFR and EGFR inhibitor, in advanced non-small-cell lung cancer: a systematic review and metaanalysis. Asian Pac J Cancer Prev, 12, 2857-63.
- Klionsky DJ, Abdalla FC, Abeliovich H, et al (2012). Guidelines for the use and interpretation of assays for monitoring autophagy. Autophagy, 8, 445-544. https://doi.org/10.4161/auto.19496
- Li R, Sun L, Wang J, et al (2012). Pemetrexed versus docetaxel in second line non-small-cell lung cancer: Results and subsets analyses of a multi-center, randomized, exploratory trial in Chinese patients. Pulm Pharmacol Ther, 25, 364-70. https://doi.org/10.1016/j.pupt.2012.06.008
- Qi WX, Shen Z, Lin F, et al (2012). Comparison of the efficacy and safety of EFGR tyrosine kinase inhibitor monotherapy with standard second-line chemotherapy in previously treated advanced non-small-cell lung cancer: a systematic review and meta-analysis. Asian Pac J Cancer Prev, 13, 5177-82. https://doi.org/10.7314/APJCP.2012.13.10.5177
- Scagliotti GV, Parikh P, von Pawel J, et al (2008). Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive patients with advancedstage non-small-cell lung cancer. J Clin Oncol, 26, 3543-51. https://doi.org/10.1200/JCO.2007.15.0375
- Shi X, Yu XM, Zhang YP, et al (2013). Efficacy and safety of pemetrexed or gemcitabine combined with carboplatin as the first-line therapy in elderly patients with advanced non-small cell lung cancer. Zhonghua Zhong Liu Za Zhi, 35, 221-4.
- Siegel R, Naishadham D, Jemal A (2012). Cancer statistics. CA:Cancer J Clin, 62, 10-29. https://doi.org/10.3322/caac.20138
- Socinski MA, Raju RN, Stinchcombe T, et al (2010). Randomized, phase II trial of pemetrexed and carboplatin with or without enzastaurin versus docetaxel and carboplatin as first-line treatment of patients with stage IIIB/IV nonsmall cell lung cancer. J Thorac Oncol, 5, 1963-69. https://doi.org/10.1097/JTO.0b013e3181fd42eb
- Chen M, Zhou CC, Zhang J (2008) Comparison of the curative effects of Pemetrexed and Docetaxel in patients with nonsmall-cell lung cancer. J Tong Ji University, 29, 54-7.
- Alimujiang S, Zhang T, Han Z G, et al (2013). Epidermal growth factor receptor tyrosine kinase inhibitor versus placebo as maintenance therapy for advanced non-small-cell lung cancer: a meta-analysis of randomized controlled trials. Asian Pac J Cancer Prev, 14, 2413-19. https://doi.org/10.7314/APJCP.2013.14.4.2413
- Baldwin CM, Perry CM (2009) Pemetrexed: a review of its use in the management of advanced non-squamous non-small cell lung cancer. Drugs, 69, 2279-302. https://doi.org/10.2165/11202640-000000000-00000
- Calvert H (1999). An overview of folate metabolism: features relevant to the action and toxicities of antifolate anticancer agents. Semin Oncol, 26, 3-10.
- Fathi AT, Brahmer JR (2008). Chemotherapy for advanced stage non-small cell lung cancer. Semin Thorac Cardiovasc Surg, 20, 210-6. https://doi.org/10.1053/j.semtcvs.2008.09.002
- Govindan R, Page N, Morgensztern D, et al (2006). Changing epidemiology of small-cell lung cancer in the United States over the last 30 years: analysis of the surveillance, epidemiologic, and end results database. J Clin Oncol, 24, 4539-44. https://doi.org/10.1200/JCO.2005.04.4859
- Guo RR, Cu FH, Sun HY (2008). Docetaxel as a Second-line Treatment for Patients with Advanced Non Small Cell Lung Cancer: A Systematic Review. Chinese J Evidence-based Med, 8, 861-68.
- Hanna N, Shepherd FA, Fossella FV, et al (2004). Randomized phase III trial of pemetrexed versus docetaxel in patients with non-small-cell lung cancer previously treated with chemotherapy. J Clin Oncol, 22, 1589-97. https://doi.org/10.1200/JCO.2004.08.163
- Higgins J, Green S (2005). Cochrane handbook for systematic reviews of interventions 4.2. 5 [J]. The Cochrane Library (3).
- Adjei AA (2004) Pharmacology and mechanism of action of pemetrexed. Clinical Lung Cancer, 5, 51-5. https://doi.org/10.3816/CLC.2004.s.003
- The Response, Outcome and Toxicity of Aggressive Palliative Thoracic Radiotherapy for Metastatic Non-Small Cell Lung Cancer Patients with Controlled Extrathoracic Diseases vol.10, pp.12, 2015, https://doi.org/10.1371/journal.pone.0145936
- Efficacy and Survival-associated Factors with Gefitinib Combined with Cisplatin and Gemcitabine for Advanced Non-small Cell Lung Cancer vol.15, pp.24, 2015, https://doi.org/10.7314/APJCP.2014.15.24.10967
- Current Drugs and Drug Targets in Non-Small Cell Lung Cancer: Limitations and Opportunities vol.16, pp.10, 2015, https://doi.org/10.7314/APJCP.2015.16.10.4147
- Meta-analysis of published efficacy and safety data for docetaxel in second-line treatment of patients with advanced non-small-cell lung cancer vol.77, pp.3, 2016, https://doi.org/10.1007/s00280-015-2957-7