Background
Pemetrexed is a multitargeted antifolate enzyme inhibitor, which has activity against a variety of tumors, including advanced
gastric cancer (AGC). The aim of this study was to assess efficacy and safety of pemetrexed plus cisplatin (PemCis) combination
in the treatment of AGC in Korean patients.
Patients and methods
This was a multicenter, single arm, open label study. Patients with no prior palliative chemotherapy received pemetrexed 500 mg/m2 and cisplatin 75 mg/m2 day 1, every 3 weeks plus folic acid and vitamin B12 supplementation. Response rate was assessed according to response evaluation criteria in solid tumors (RECIST) criteria.
Results
Of the 50 patients evaluable for efficacy, 13 had partial response for an overall response rate of 26% (95% CI, 14.6–40.3%)
and 15 (30%) had stable disease. Median time to progression was 2.8 months (95%CI, 2.2–4.4 months), and median overall survival
was 6.6 months (95% CI, 4.8–10.4 months). Of the 51 patients evaluable for safety, the most frequent NCI-CTC grade 3/4 toxicities
were neutropenia in 49% of patients (25% of cycles) and anorexia in 10% of patients (4% of cycles).
Conclusion
PemCis has a modest activity and acceptable toxicity profile in patients with AGC. Clinical trials with different combinations
and dose regimens are, therefore, warranted.
Keywords Advanced gastric cancer - Chemotherapy - Cisplatin - Pemetrexed - Phase II trial