Can combination chemotherapy make a difference?

This phase III clinical trial compared the efficacy of pemetrexed (Alimta) chemotherapy alone, versus the combination of carboplatin plus pemetrexed, as first treatment for patients with advanced non small-cell lung cancer (NSCLC)

NSCLC is the most common type of lung cancer and often requires chemotherapy. Chemotherapeutic agents such as carboplatin and pemetrexed are used to kill cancer cells and prevent new cells from growing. Which chemotherapy drugs are the most beneficial, as well as their optimal dosages and combinations, are still a matter of debate.  

This study included 205 patients diagnosed with advanced NSCLC. Patients were assigned into one of two treatment groups. 102 patients were treated with a single chemotherapeutic drug, pemetrexed. 103 patients received combination treatment with pemetrexed and carboplatin. Both therapies were administered every 3 weeks for a total of four cycles.

Response to treatment was observed in 10.3% of patients treated with pemetrexed alone, compared to 23.8% of patients in the combined therapy group. Progression-free survival (PFS; the time between therapy and until the disease worsens or progresses) was 2.8 months for patients treated with pemetrexed alone, and 5.8 months for patients in the combined treatment group. Survival rates after one year were 21.9% of patients treated with pemetrexed alone, and 40.1% of patients in the combined treatment group. However, adverse effects such as neutropenia (low white blood cell count that may lead to infections) and sepsis (severe infection) were more common in the combination treatment group. Four treatment-related deaths were reported with combined carboplatin and pemetrexed treatment.

This study concluded that combination chemotherapy with carboplatin and pemetrexed improves both overall survival and PFS compared to the standard single-agent therapy.

Consult with your physician regarding the different chemotherapy regimens available for the treatment of non small-cell lung cancer.