New Drug May Offer Hope to Some With Lung Cancer

Maintenance therapy with the drug pemetrexed improves the survival of people with non-small-cell lung cancer whose disease has not progressed after chemotherapy, a new study has found.

Nearly 90 percent of all people who die from lung cancer have non-small-cell tumors. At the time the cancer is discovered, it's considered advanced about 40 percent of the time, according to background information in a news release from The Lancet, which is publishing the study. Chemotherapy reduces the tumors in just 40 percent of advanced cases, it said.
The phase 3 study included 663 people in 20 countries who had an advanced stage of the cancer but no disease progression after four cycles of platinum-based chemotherapy. They were randomly selected to be given pemetrexed or a placebo in 21-day cycles.

The cancers did not progress for 4.3 months, on average, in people in the pemetrexed group, compared with 2.6 months in the placebo group, the study found. People given pemetrexed survived an average of 13.4 months, compared with 10.6 months for those given the placebo.

That means that those in the pemetrexed group had a 50 percent reduction in the risk for disease progression or death and a 21 percent reduction in the risk of death only, the researchers said.

Drug-related toxic effects caused discontinuation of treatment in 5 percent of the pemetrexed group and 4 percent of the placebo group. No deaths were found to be related to pemetrexed, according to the study.

"Pemetrexed maintenance therapy is well tolerated and offers significantly improved progression-free and overall survival compared with placebo, making it a new treatment option for patients with advanced non-squamous, non-small-cell lung cancer who do not progress after initial induction therapy," Dr. Chandra Belani, of the Penn State Hershey Cancer Institute, and her colleagues concluded.

The study, which appears online and in an upcoming print issue of The Lancet, was released Sept. 19 to coincide with the European Cancer Organization meeting.

Dr. Thomas Stinchcombe of the Lineberger Comprehensive Cancer Center at the University of North Carolina, and Dr. Howard West, of the Swedish Cancer Institute in Seattle, wrote in an accompanying editorial that the use of pemetrexed as maintenance therapy "merits being considered as a strong option, reflected by the recent approval of pemetrexed in this setting by the European Medicines Agency and the U.S. Food and Drug Administration."