According to results presented at the 2007 International Association for the Study of Lung Cancer (IASLC), initial therapy with Alimta® (pemetrexed) combined with a platinum agent (Platinol® [cisplatin] or Paraplatin® [carboplatin]) provides the same survival as Gemzar® (gemcitabine), but with less side effects, for patients with advanced non–small cell lung cancer.

Lung cancer remains the leading cause of cancer-related deaths in the world. Lung cancer is responsible for more deaths than breast cancer, colon cancer, and prostate cancer combined. Non–small cell lung cancer (NSCLC) is the most common type of lung cancer, comprising approximately 75% of all lung cancers in the United States. “Non–small cell” refers to the type of cell within the lung where the cancer originated.

Once NSCLC has become advanced and has spread from its site of origin, cure rates remain suboptimal. Quality of life is an important consideration for patients being treated for advanced NSCLC; therefore, side effects of therapy remain a focus of research.

Chemotherapy remains the cornerstone of treatment for advanced NSCLC. Treatment typically includes a platinum agent coupled with another chemotherapy agent, such as Gemzar. However, researchers continue to compare different chemotherapy combinations to study their overall effectiveness and impact on quality of life.

One clinical trial conducted by researchers from Italy compared Alimta plus Platinol to Gemzar/Platinol as initial therapy in 1,725 patients with advanced NSCLC.[[1]](http://news.cancerconnect.com/alimta-and-platinum-combination-provides-same-survival-as-gemzar-in-non-small-cell-lung-cancer/#_edn1 "_ednref1")

  • Among patients with a specific subtype of NSCLC, non-squamous cell cancer, survival was improved among those treated with Alimta/Platinol compared with those treated with Gemzar/Platinol (11.8 months versus 10.4 months, respectively).
  • Among patients with squamous cell NSCLC, survival was improved among those treated with Gemzar/Platinol (10.8 months) compared with those treated with Alimta/Platinol (9.36 months).
  • Overall survival was not different between patients treated with Alimta/Platinol compared with those treated with Gemzar/Platinol.
  • Side effects tended to be decreased among patients treated with Alimta/Platinol compared with those treated with Gemzar/Platinol; with the exception of blood clots, fatigue, and nausea, all side effects were reduced among patients treated with Alimta/Platinol.

A second clinical trial evaluating Alimta as initial therapy in advanced NSCLC was conducted by researchers from Norway.[[2]](http://news.cancerconnect.com/alimta-and-platinum-combination-provides-same-survival-as-gemzar-in-non-small-cell-lung-cancer/#_edn2 "_ednref2") Patients in this trial were treated with either Alimta plus Paraplatin or Gemzar plus Paraplatin.

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  • Overall survival was similar between the two groups of patients (7.3 months for those treated with Alimta/Paraplatin and 7.0 months for those treated with Gemzar/Paraplatin).
  • Quality of life was also similar between the two groups of patients. It was noted that rates of red blood cell or platelet transfusions were significantly reduced among patients treated with Alimta/Paraplatin compared with those treated with Gemzar/Paraplatin.

The researchers concluded that Alimta plus a platinum compound appears to provide at least equivalent survival compared with Gemzar plus a platinum compound as initial therapy for advanced NSCLC. Treatment with Alimta may also reduce side effects associated with treatment and is available for administration once per month, versus twice per month with Gemzar. At this time Alimta is not FDA-approved for initial therapy for NSCLC; however, the FDA is currently in the review process for its use in this indication.

References:

[[1]](http://news.cancerconnect.com/alimta-and-platinum-combination-provides-same-survival-as-gemzar-in-non-small-cell-lung-cancer/#_ednref1 "_edn1") Scagliotti G, et al Phase III Study of Pemetrexed Plus Cisplatin Versus Gemcitabine Plus Cisplatin in Chemonaive patients with Locally Advanced or Metastatic Non-Small Cell Lung Cancer (NSCLC). Proceedings from the International Association for the Study of Lung Cancer meeting. 2007. Abstract #PRS-03.

[[2]](http://news.cancerconnect.com/alimta-and-platinum-combination-provides-same-survival-as-gemzar-in-non-small-cell-lung-cancer/#_ednref2 "_edn2") Gronberg B, et al. A Phase III Study by the Norwegian Lung Cancer Group: Pemetrexed + Carboplatin vs. Gemcitabine + Carboplatin as First-Line Chemotherapy in Stage IIIB/IV Non-Small Cell Lung Cancer. Proceedings from the International Association for the Study of Lung Cancer meeting. 2007. Abstract A3-04.

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