Evaluation of Response and Toxicity of Pemetrexed-Carboplatin Versus Paclitaxel-Carboplatin as First-Line Treatment in Metastatic Non-Squamous Non-Small Cell Lung Cancer

Evaluation of Response and Toxicity of Pemetrexed-Carboplatin Versus Paclitaxel-Carboplatin as First-Line Treatment in Metastatic Non-Squamous Non-Small Cell Lung Cancer

Author(s): Sarkar Uday Kumar
Citation: Sarkar, U. K., Alam, S., Hoque, A., Sarker, N. K., & Mahmud, T. (2025). Evaluation of Response and Toxicity of Pemetrexed-Carboplatin Versus Paclitaxel- Carboplatinas First-Line Treatment in Metastatic Non-Squamous Non-Small Cell Lung Cancer, Chronicles of Clinical Reviews and Case Reports, The Geek Chronicles, 1, 1-9.
Address / Description:

1* Medical Officer National Institute of Cancer Research & Hospital, Dhaka

2 Department of Clinical Oncology Bangabandhu Sheikh Mujib Medical University, Dhaka

3 Department of Radiotherapy, Dhaka Medical College Hospital, Dhaka

4 Department of Radiotherapy, Shaheed Ziaur Rahman Medical College Hospital, Bogura

5 Department of Public Health North South University

Copyright: © 2025 U Kumar Sarkar, this is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received On: February 17, 2025
Accepted On: March 5, 2025
Published On: March 15, 2025
Abstract:

Non-small cell lung cancer (NSCLC) accounts for 80-85% of all lung cancer approximately. The paclitaxel-carboplatin combination is the established standard regimen of choice in metastatic NSCLC.  Pemetrexed, a folate antimetabolite is also effective against non-small cell lung cancer.  To compare the response and toxicity of the Pemetrexed-Carboplatin regimen with Paclitaxel-Carboplatin in the treatment of metastatic NSCLC.   This Quasi-experimental study was conducted from three centers of Dhaka city. 80 patients (40 patients on each arm) who met the inclusion criteria of the study were enrolled. Arm-A received 500mg/m2 Pemetrexed (Day 1) plus Carboplatin; AUC=5 (Day 1) IV, in another arm, 175mg/m2 Paclitaxel (Day 1) plus Carboplatin AUC=6; (Day 1) IV, dexamethasone was given 12 mg on night before and on the morning of chemotherapy of each cycle & repeated every 21 days for 6 cycles; were given. Both outcome and toxicities were evaluated. Regarding the tumor control, there was no statistically significant difference in both arms at the follow-up after 6 weeks of completion of chemotherapy [Partial response was seen in 24 (60.00%) patients in Arm-A and in 22 (55.00%) patients in Arm-B, p= 0.58]. Grade ≥3 neutropenia was seen in 09 (22.50%) patients of the Arm-A and 20 (50.00%) patients of Arm-B, p<0.005. Treatment-emergent alopecia was significantly higher in Arm-B [Arm-A, 07 (17.50%) vs Arm-B, 22 (55.00%) p<0.05]. Other non-hematological toxicity was also assessed in both arms and there was no significant difference in the frequency of adverse events. This study supports the fact that Pemetrexed-Carboplatin-based chemotherapy may be equally effective with less haematologic & non-haematologic toxicity than the Paclitaxel-Carboplatin-based chemotherapy regimen.

Keywords: Response; toxicity; Paclitaxel; Carboplatin; NSCLC.

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