PMID- 33313113
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220418
IS  - 2305-5839 (Print)
IS  - 2305-5847 (Electronic)
IS  - 2305-5839 (Linking)
VI  - 8
IP  - 21
DP  - 2020 Nov
TI  - Analysis of pemetrexed-based chemotherapy in the treatment of advanced colorectal 
      cancer.
PG  - 1368
LID - 10.21037/atm-20-1095 [doi]
LID - 1368
AB  - BACKGROUND: In this study, we evaluated the therapeutic efficacy and toxicity 
      profile of chemotherapy combinations containing pemetrexed for patients with 
      metastatic colorectal cancer. We investigated the optimal chemotherapy treatment 
      regimen to provide a new option for third-line or after treatment of patients 
      with advanced colorectal cancer. METHODS: A total of 88 eligible patients with 
      metastatic colorectal cancer were included in this study from April 2009 to March 
      2019 at the Department of Oncology, the First Affiliated Hospital of Nanjing 
      Medical University. The baseline information and treatment outcomes of the 
      patients were collected. Statistical analyses of different chemotherapy regimens 
      focusing on objective response rate (ORR), disease control rate (DCR), 
      progression-free survival (PFS), overall survival (OS), and toxicity were 
      conducted. The superior treatment regimen was determined, and its clinical 
      outcomes were compared with those of the other treatment combinations to explore 
      the factors that potentially contributed to the curative effect. RESULTS: The 88 
      patients in this study received 18 treatment regimens. In total, 53 patients had 
      progressive disease (PD), 34 patients had stable disease (SD), 1 patient was 
      assessed as complete response (CR), and no patients had a partial response (PR). 
      The optimal regimen was pemetrexed + S-1 + bevacizumab. The 21 patients treated 
      with this regimen exhibited a higher DCR [61.90% vs. 32.84%, odds ratio (OR) 
      =3.324; 95% confidence interval (CI): 1.201-9.196, P=0.018] than patients treated 
      with the other chemotherapy regimens. Moreover, the median PFS of this regimen 
      was 4.57 (2.62-6.51) months, which was significantly longer [hazard ratio (HR) 
      =0.566; 95% CI: 0.330-0.971, P=0.039] than the 2.57 (2.18-2.95) months of the 
      other regimens. In terms of toxicity, leukopenia (34.1%) and neutropenia (34.1%) 
      had the highest incidence of all-grade adverse events (AEs). Grade 3-4 AEs 
      included neutropenia (15.9%), leukopenia (11.4%), thrombocytopenia (2.3%), and 
      anemia (1.1%). CONCLUSIONS: The combination of pemetrexed + S-1 + bevacizumab was 
      found to be the optimal treatment regimen. This combination was superior to the 
      other treatment regimens in terms of DCR and PFS with controllable toxicity. 
      These results warrant further prospective exploratory clinical trials for 
      pemetrexed-based chemotherapy in metastatic colorectal cancer.
CI  - 2020 Annals of Translational Medicine. All rights reserved.
FAU - Yu, Zhengyi
AU  - Yu Z
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Wang, Jiawei
AU  - Wang J
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Cai, Xiaomin
AU  - Cai X
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Gao, Zhenzhen
AU  - Gao Z
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
FAU - Wang, Sailan
AU  - Wang S
AD  - Department of Obstetrics and Gynecology, the First Affiliated Hospital of Nanjing 
      Medical University, Nanjing, China.
FAU - Gu, Yanhong
AU  - Gu Y
AD  - Department of Oncology, the First Affiliated Hospital of Nanjing Medical 
      University, Nanjing, China.
LA  - eng
PT  - Journal Article
PL  - China
TA  - Ann Transl Med
JT  - Annals of translational medicine
JID - 101617978
PMC - PMC7723524
OTO - NOTNLM
OT  - Metastatic colorectal cancer
OT  - advanced colorectal cancer
OT  - pemetrexed
OT  - third-line treatment
COIS- Conflicts of Interest: All authors have completed the ICMJE uniform disclosure 
      form (available at http://dx.doi.org/10.21037/atm-20-1095). The authors have no 
      conflicts of interest to declare.
EDAT- 2020/12/15 06:00
MHDA- 2020/12/15 06:01
PMCR- 2020/11/01
CRDT- 2020/12/14 10:59
PHST- 2020/12/14 10:59 [entrez]
PHST- 2020/12/15 06:00 [pubmed]
PHST- 2020/12/15 06:01 [medline]
PHST- 2020/11/01 00:00 [pmc-release]
AID - atm-08-21-1368 [pii]
AID - 10.21037/atm-20-1095 [doi]
PST - ppublish
SO  - Ann Transl Med. 2020 Nov;8(21):1368. doi: 10.21037/atm-20-1095.