Several clinical experiments have attempted to improve the survival rates of patients dealing with non-small cell lung cancer (NSCLC) by stretching out the time span involved in the first stage of treatment. The idea behind this method, also known as maintenance therapy, is to attack the tumor after its initial regression stage instead of delaying further treatment until the patient recovers from the first round. In most documented cases, this effort has not achieved the desired success rate.
While there have been a number of divergent opinions on the function of maintenance therapy, most cancer researchers agree on the length of time needed for first-line chemotherapy for patients diagnosed with later-stage NSCLC. Typically, four cycles, but sometimes up to six, of first-line chemotherapy treatments should be comprised of two or more drugs. These treatments often include a platinum chemotherapy remedy like cisplatin or carboplatin. Several trials have demonstrated that these platinum-based remedies are extremely efficient in dealing with the cancer. However, any treatment regimen that extends to more than six cycles begins to show diminishing returns without any noticeable benefit to the patient.
One drug used in the initial treatment of NSCLC is pemetrexed, sold under the brand name Alimta. Pemetrexed has been in use for the treatment of mesothelioma, a cancer affecting the membrane that lines the lungs. Recently, the makers of pemetrexed received approval from the US Food and Drug Administration (FDA) to be used in maintenance therapy for the disease. In one phase III trial, pemetrexed has improved the survival rates in patients with NSCLC to just over fifteen months, a fifty percent increase over the current mode of supportive care. This method also saw the rate of patients whose disease progressed while under treatment decrease by a large margin.
According to the lead investigator during the trial, Dr. Chandra Belani, these findings have shown an effective method for maintenance therapy in patients with nonsquamous NSCLC. With the small percentage of side effects and the increased survival rates, Dr. Belani believes that these never-before-seen benefits to patients with advanced NSCLC have rightfully earned the FDA’s approval.
Dr. Richard Pazdur, director of the Office of Oncology Drug Products for the FDA, mentioned that the maintenance therapy routine that includes pemetrexed shows a new way to deal with treatment of advanced or metastasized nonsquamous NSCLC. The main reaction in pemetrexed is that it creates issues with cell reproduction in cases of late-stage cancer by interfering with the cell’s metabolism. Cells require the B-vitamin folate to reproduce; pemetrexed tampers with the cell’s ability to metabolize folate and prevents the cells from replicating.
Dr. Mark Socinski of the University of North Carolina’s Lineberger Comprehensive Cancer Center also stated the importance of the use of previously approved treatments that could also be used as maintenance therapy remedies. He stressed that maintenance therapies represent an important advance in improving survival rates for patients with NSCLC, especially since even effective first-line treatments were rare just a few years ago. He also said that patient education is crucial in employing these new strategies. If a patient’s symptoms become more active and more painful, he says, then doctors should let them know that maintenance therapies are available to help them through the disease.
Sources: National Cancer Institute, Oncology Nursing News
