PMID- 23259416
OWN - NLM
STAT- MEDLINE
DCOM- 20130919
LR  - 20191112
IS  - 1876-1038 (Electronic)
IS  - 1574-8871 (Linking)
VI  - 8
IP  - 1
DP  - 2013 Mar
TI  - The PARAMOUNT trial: a phase III randomized study of maintenance pemetrexed 
      versus placebo immediately following induction first-line treatment with 
      pemetrexed plus cisplatin for advanced nonsquamous non-small cell lung cancer.
PG  - 23-8
AB  - The search for new agents and for innovative strategies is warranted in the 
      treatment of advanced non small cell lung cancer (NSCLC) because the outcomes 
      remain unsatisfactory for most patients. Maintenance treatment with either a 
      chemotherapeutic agent or a molecularly targeted agent after first-line 
      chemotherapy is a very interesting strategy that has been largely investigated in 
      the last years. Maintenance treatment can consist of drugs included in the 
      induction regimen (continuation maintenance) or other non-cross-resistant agents 
      not included in the induction regimen (switch maintenance). The switch 
      maintenance strategy with the Epidermal Growth Factor Receptor Tyrosine Kinase 
      Inhibitor erlotinib (in all the histologies) or with pemetrexed (in non-squamous 
      histologies) have been demonstrated to be two possible effective options versus 
      the classic break from cytotoxic chemotherapy after a fixed course in the 
      treatment of advanced NSCLC. However some biases may have influenced the outcomes 
      of switch maintenance trials as the low rate of patients treated with erlotinib 
      and pemetrexed in the placebo arms. Very recently, a randomized phase III trial 
      named PARAMOUNT has demonstrated a clinically significant benefit in overall 
      survival with a good safety profile versus placebo in favour of continuation 
      maintenance with pemetrexed after four cycles of induction with cisplatin plus 
      pemetrexed. Continuation maintenance can be considered the true maintenance 
      strategy because switch maintenance is an early second-line treatment. 
      Continuation maintenance with pemetrexed after cisplatin plus pemetrexed 
      induction for patients selected for a maintenance strategy is recommended as 
      first-line treatment of advanced non-squamous NSCLC.
FAU - Gridelli, Cesare
AU  - Gridelli C
AD  - Division of Medical Oncology, "S.G. Moscati" Hospital, Contrada Amoretta, 8, 
      83100 Avellino, Italy. cgridelli@libero.it
FAU - Maione, Paolo
AU  - Maione P
FAU - Rossi, Antonio
AU  - Rossi A
LA  - eng
PT  - Journal Article
PL  - United Arab Emirates
TA  - Rev Recent Clin Trials
JT  - Reviews on recent clinical trials
JID - 101270873
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Glutamates)
RN  - 0 (Protein Kinase Inhibitors)
RN  - 0 (Quinazolines)
RN  - 04Q9AIZ7NO (Pemetrexed)
RN  - 5Z93L87A1R (Guanine)
RN  - DA87705X9K (Erlotinib Hydrochloride)
RN  - Q20Q21Q62J (Cisplatin)
SB  - IM
MH  - Antineoplastic Agents/*administration & dosage
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*drug therapy/pathology
MH  - Cisplatin/administration & dosage
MH  - Clinical Trials, Phase III as Topic
MH  - Disease Progression
MH  - Disease-Free Survival
MH  - Erlotinib Hydrochloride
MH  - Glutamates/*administration & dosage
MH  - Guanine/administration & dosage/*analogs & derivatives
MH  - Humans
MH  - Lung Neoplasms/*drug therapy/pathology
MH  - Pemetrexed
MH  - Protein Kinase Inhibitors/therapeutic use
MH  - Quinazolines/therapeutic use
MH  - Randomized Controlled Trials as Topic
EDAT- 2012/12/25 06:00
MHDA- 2013/09/21 06:00
CRDT- 2012/12/25 06:00
PHST- 2012/07/29 00:00 [received]
PHST- 2012/11/14 00:00 [revised]
PHST- 2012/11/30 00:00 [accepted]
PHST- 2012/12/25 06:00 [entrez]
PHST- 2012/12/25 06:00 [pubmed]
PHST- 2013/09/21 06:00 [medline]
AID - RRCT-EPUB-20121211-1 [pii]
AID - 10.2174/15748871112079990040 [doi]
PST - ppublish
SO  - Rev Recent Clin Trials. 2013 Mar;8(1):23-8. doi: 10.2174/15748871112079990040.