Clinical observation of pemetrexed combined with cisplatin as second-line treatment in advanced gastric cancer

JIAO Anna; JIN Jianhua; LU Wenbin; DENG Jianzhong; ZHANG Hua; LIU Yungang

Abstract：Objective To evaluate the efficacy and toxicity of pemetrexed combined with cisplatin as second-line treatment in advanced gastric cancer. Methods Forty-six patients with advanced gastric cancer who had previously failed to first-line chemotherapy from December 2011 to February 2013 received pemetrexed (500mg/m2 iv, d1) combined with cisplatin (25mg/m2 iv, d1-d3) as second-line treatment. Twenty-one days was a cycle. The response evaluation criteria in solid tumors ( RECIST) 1?0 was employed to evaluate the short-term efficacy and calculated the response rate (RR) and disease control rate (DCR). The toxicity was evaluated using NCI CTC 3?0 criteria. Progression-free survival (PFS) and overall survival (OS) were calculated from the date of follow-up. Results Forty-six patients were evaluable for short-term efficacy. There were 10 cases of partial response, 12 of stable disease and 24 of progressive disease with RR of 21?7%and DCR of 47?8%. The follow-up ranged from 3 to 20 months. The median PFS and OS were 3?5 and 8?4 months, re-spectively. The KPS was 77?6±4?3 after chemotherapy, higher than 65?7±5?0 before chemotherapy, but there was no significant differ-ence on painkiller usage before and after chemotherapy. The major side effects were grade 1-3 marrow toxicities and gastrointestinal re-sponse. The incidence of grade 4 side effect was rare with only one case of grade 4 leukopenia. Two cases were grade 1 abnormal liver function. There was no renal dysfunction, fever, rash and chemotherapy-related deaths. Conclusion Pemetrexed combined with cisplatin as second-line treatment in advanced gastric cancer showed a good effect with mild toxicities and good tolerance.