Pemetrexed and carboplatin combination therapy followed by pemetrexed maintenance in Japanese patients with non-squamous non-small cell lung cancer: A subgroup analysis of elderly patients

Naoyuki Nogami, Makoto Nishio, Isamu Okamoto, Sotaro Enatsu, Kazumi Suzukawa, Hiroki Takai, Kazuhiko Nakagawa, Tomohide Tamura

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Abstract

Background: The combination of pemetrexed and carboplatin is commonly used for the treatment of advanced non-squamous non-small cell lung cancer (NSCLC), mainly because it is comparatively effective and less toxic than other platinum-doublet therapies. Using the JMII (JACAL) study, we report the efficacy and safety of this treatment followed by pemetrexed maintenance in the elderly population (≥70 years of age). Methods: The JMII study was a multicenter, post-marketing study that assessed the efficacy and safety of carboplatin (AUC6) and pemetrexed (500 mg/m 2 , given on Day 1 of a 21-day cycle, 4 cycles) followed by pemetrexed (500 mg/m 2 ) maintenance in advanced non-squamous NSCLC patients (n = 109). Retrospective subgroup analyses were performed in elderly patients aged ≥70. Results: The study includes younger (<70 years, n = 84) and elderly (≥70 years, n = 25) patients who received induction therapy. Median progression-free survival and overall survival from the start of the induction phase were 5.2 (95% CI: 3.5, 8.2) and 16.8 (95% CI: 10.3, NC) months for the elderly patients compared with 5.8 (95% CI: 4.3, 7.4) and 20.5 (95% CI: 16.7, NC) months for the younger patients, respectively. Grade 3/4 hematologic toxicities were more frequent in the elderly patients. Non-hematologic toxicities in the elderly patients were comparable to those in younger patients. Dose reduction was more common in the elderly (44% vs 23%), due to hematologic toxicities. Conclusions: There was no difference in efficacy (evaluated by progression-free survival) between elderly and younger patients. Although grade 3/4 hematologic toxicities were frequently observed in the elderly patients, they were easily managed with dose adjustment.

Original languageEnglish
Pages (from-to)27-33
Number of pages7
JournalRespiratory Investigation
Volume57
Issue number1
DOIs
Publication statusPublished - Jan 1 2019

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Pemetrexed
Carboplatin
Non-Small Cell Lung Carcinoma
Maintenance
Therapeutics
Disease-Free Survival
Safety
Poisons
Marketing
Platinum

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine

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Pemetrexed and carboplatin combination therapy followed by pemetrexed maintenance in Japanese patients with non-squamous non-small cell lung cancer : A subgroup analysis of elderly patients. / Nogami, Naoyuki; Nishio, Makoto; Okamoto, Isamu; Enatsu, Sotaro; Suzukawa, Kazumi; Takai, Hiroki; Nakagawa, Kazuhiko; Tamura, Tomohide.

In: Respiratory Investigation, Vol. 57, No. 1, 01.01.2019, p. 27-33.

Research output: Contribution to journalArticle

Nogami, Naoyuki ; Nishio, Makoto ; Okamoto, Isamu ; Enatsu, Sotaro ; Suzukawa, Kazumi ; Takai, Hiroki ; Nakagawa, Kazuhiko ; Tamura, Tomohide. / Pemetrexed and carboplatin combination therapy followed by pemetrexed maintenance in Japanese patients with non-squamous non-small cell lung cancer : A subgroup analysis of elderly patients. In: Respiratory Investigation. 2019 ; Vol. 57, No. 1. pp. 27-33.
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abstract = "Background: The combination of pemetrexed and carboplatin is commonly used for the treatment of advanced non-squamous non-small cell lung cancer (NSCLC), mainly because it is comparatively effective and less toxic than other platinum-doublet therapies. Using the JMII (JACAL) study, we report the efficacy and safety of this treatment followed by pemetrexed maintenance in the elderly population (≥70 years of age). Methods: The JMII study was a multicenter, post-marketing study that assessed the efficacy and safety of carboplatin (AUC6) and pemetrexed (500 mg/m 2 , given on Day 1 of a 21-day cycle, 4 cycles) followed by pemetrexed (500 mg/m 2 ) maintenance in advanced non-squamous NSCLC patients (n = 109). Retrospective subgroup analyses were performed in elderly patients aged ≥70. Results: The study includes younger (<70 years, n = 84) and elderly (≥70 years, n = 25) patients who received induction therapy. Median progression-free survival and overall survival from the start of the induction phase were 5.2 (95{\%} CI: 3.5, 8.2) and 16.8 (95{\%} CI: 10.3, NC) months for the elderly patients compared with 5.8 (95{\%} CI: 4.3, 7.4) and 20.5 (95{\%} CI: 16.7, NC) months for the younger patients, respectively. Grade 3/4 hematologic toxicities were more frequent in the elderly patients. Non-hematologic toxicities in the elderly patients were comparable to those in younger patients. Dose reduction was more common in the elderly (44{\%} vs 23{\%}), due to hematologic toxicities. Conclusions: There was no difference in efficacy (evaluated by progression-free survival) between elderly and younger patients. Although grade 3/4 hematologic toxicities were frequently observed in the elderly patients, they were easily managed with dose adjustment.",
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T1 - Pemetrexed and carboplatin combination therapy followed by pemetrexed maintenance in Japanese patients with non-squamous non-small cell lung cancer

T2 - A subgroup analysis of elderly patients

AU - Nogami, Naoyuki

AU - Nishio, Makoto

AU - Okamoto, Isamu

AU - Enatsu, Sotaro

AU - Suzukawa, Kazumi

AU - Takai, Hiroki

AU - Nakagawa, Kazuhiko

AU - Tamura, Tomohide

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background: The combination of pemetrexed and carboplatin is commonly used for the treatment of advanced non-squamous non-small cell lung cancer (NSCLC), mainly because it is comparatively effective and less toxic than other platinum-doublet therapies. Using the JMII (JACAL) study, we report the efficacy and safety of this treatment followed by pemetrexed maintenance in the elderly population (≥70 years of age). Methods: The JMII study was a multicenter, post-marketing study that assessed the efficacy and safety of carboplatin (AUC6) and pemetrexed (500 mg/m 2 , given on Day 1 of a 21-day cycle, 4 cycles) followed by pemetrexed (500 mg/m 2 ) maintenance in advanced non-squamous NSCLC patients (n = 109). Retrospective subgroup analyses were performed in elderly patients aged ≥70. Results: The study includes younger (<70 years, n = 84) and elderly (≥70 years, n = 25) patients who received induction therapy. Median progression-free survival and overall survival from the start of the induction phase were 5.2 (95% CI: 3.5, 8.2) and 16.8 (95% CI: 10.3, NC) months for the elderly patients compared with 5.8 (95% CI: 4.3, 7.4) and 20.5 (95% CI: 16.7, NC) months for the younger patients, respectively. Grade 3/4 hematologic toxicities were more frequent in the elderly patients. Non-hematologic toxicities in the elderly patients were comparable to those in younger patients. Dose reduction was more common in the elderly (44% vs 23%), due to hematologic toxicities. Conclusions: There was no difference in efficacy (evaluated by progression-free survival) between elderly and younger patients. Although grade 3/4 hematologic toxicities were frequently observed in the elderly patients, they were easily managed with dose adjustment.

AB - Background: The combination of pemetrexed and carboplatin is commonly used for the treatment of advanced non-squamous non-small cell lung cancer (NSCLC), mainly because it is comparatively effective and less toxic than other platinum-doublet therapies. Using the JMII (JACAL) study, we report the efficacy and safety of this treatment followed by pemetrexed maintenance in the elderly population (≥70 years of age). Methods: The JMII study was a multicenter, post-marketing study that assessed the efficacy and safety of carboplatin (AUC6) and pemetrexed (500 mg/m 2 , given on Day 1 of a 21-day cycle, 4 cycles) followed by pemetrexed (500 mg/m 2 ) maintenance in advanced non-squamous NSCLC patients (n = 109). Retrospective subgroup analyses were performed in elderly patients aged ≥70. Results: The study includes younger (<70 years, n = 84) and elderly (≥70 years, n = 25) patients who received induction therapy. Median progression-free survival and overall survival from the start of the induction phase were 5.2 (95% CI: 3.5, 8.2) and 16.8 (95% CI: 10.3, NC) months for the elderly patients compared with 5.8 (95% CI: 4.3, 7.4) and 20.5 (95% CI: 16.7, NC) months for the younger patients, respectively. Grade 3/4 hematologic toxicities were more frequent in the elderly patients. Non-hematologic toxicities in the elderly patients were comparable to those in younger patients. Dose reduction was more common in the elderly (44% vs 23%), due to hematologic toxicities. Conclusions: There was no difference in efficacy (evaluated by progression-free survival) between elderly and younger patients. Although grade 3/4 hematologic toxicities were frequently observed in the elderly patients, they were easily managed with dose adjustment.

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