Second-line chemotheraphy for non-small cell lung cancer: Recent data with pemetrexed

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12 Scopus citations


Platinum-based chemotherapy offers a modest survival advantage over best supportive care (BSC) in chemotherapy-naive patients with a good performance status and advanced/metastatic non-small-cell lung cancer (NSCLC). Based on 2 landmark studies that reported improved survival times and quality of life when comparing docetaxel with ifosfamide, vinorelbine, or BSC alone, docetaxel at 75 mg/m2 given once every 3 weeks has been the standard of care as second-line chemotherapy since 2000. Docetaxel given at this dose and schedule resulted in significant hematologic toxicity, with many patients at risk for neutropenic fever. Pemetrexed is a novel multitargeted antifolate agent with single-agent activity in first- and second-line treatment of NSCLC. A phase III study in 571 patients comparing pemetrexed with docetaxel demonstrated clinically equivalent therapeutic outcomes in second-line treatment of patients with recurrent NSCLC; however, patients on the pemetrexed arm had a more favorable hematologic toxicity profile, with fewer episodes of neutropenia, neutropenic fever, and infections and less use of granulocyte colony-stimulating factor support. Based on these data, pemetrexed is a reasonable second-line chemotherapy option for patients with recurrent, advanced NSCLC.

Original languageEnglish (US)
Pages (from-to)S75-S79
JournalClinical Lung Cancer
Issue numberSUPPL. 2
StatePublished - Apr 2004


  • Best supportive care
  • Docetaxel
  • Gefitinib
  • Ifosfamide
  • Multitargeted antifolate
  • Recurrent lung cancer
  • Vinorelbine

ASJC Scopus subject areas

  • Cancer Research
  • Pulmonary and Respiratory Medicine

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