Abstract:

Objective To evaluate the efficacy and toxicity of pemetrexed combined with cisplatin as second-line treatment in advanced gastric cancer. Methods Forty-six patients with advanced gastric cancer who had previously failed to first-line chemotherapy from December 2011 to February 2013 received pemetrexed （500mg／m2 iv， d1） combined with cisplatin （25mg／m2 iv， d1-d3） as second-line treatment. Twenty-one days was a cycle. The response evaluation criteria in solid tumors （RECIST） 1.0 was employed to evaluate the short-term efficacy and calculated the response rate （RR） and disease control rate （DCR）. The toxicity was evaluated using NCI CTC 3.0 criteria. Progression-free survival （PFS） and overall survival （OS） were calculated from the date of follow-up.Results Forty-six patients were evaluable for short-term efficacy. There were 10 cases of partial response， 12 of stable disease and 24 of progressive disease with RR of 21.7％ and DCR of 47.8％. The follow-up ranged from 3 to 20 months. The median PFS and OS were 3.5 and 8.4 months， respectively. The KPS was 77.6±4.3 after chemotherapy， higher than 65.7±5.0 before chemotherapy， but there was no significant difference on painkiller usage before and after chemotherapy. The major side effects were grade 1-3 marrow toxicities and gastrointestinal response. The incidence of grade 4 side effect was rare with only one case of grade 4 leukopenia. Two cases were grade 1 abnormal liver function. There was no renal dysfunction， fever， rash and chemotherapy-related deaths. Conclusion Pemetrexed combined with cisplatin as second-line treatment in advanced gastric cancer showed a good effect with mild toxicities and good tolerance.