The role of pemetrexed as maintenance treatment in advanced NSCLC: a Phase III randomized trial.

Abstract:

:A randomized Phase III trial tested the efficacy of pemetrexed as maintenance treatment in patients with advanced non-small-cell lung cancer (NSCLC) who were without progression after completing four cycles of first-line platinum-based chemotherapy. The primary endpoint of the trial was progression-free survival (PFS). Pemetrexed was significantly better than placebo both in terms of PFS and overall survival. The study was not designed as a direct comparison between 'early' and 'delayed' administration of pemetrexed because there was no mandatory cross-over in the control arm, in which less than 20% of patients actually received pemetrexed as second-line. However, a relevant proportion of patients with advanced NSCLC, due to early death or clinical deterioration, will never be able to receive a second-line treatment after disease progression. At the end of first-line treatment, the immediate administration of a drug that has not been received before (instead of adopting the 'wait and watch' approach based on stopping treatment until disease progression) could be a positive strategy, allowing patients to receive early one more potentially active drug without an unacceptable increase in toxicity. This strategy should be discussed with patients. Prespecified analysis of efficacy by tumor histology showed a significant interaction between treatment and histology, with pemetrexed producing significant and clinically meaningful benefit compared to placebo in the non-squamous group, without efficacy in patients with squamous tumors.

authors

Gridelli C,Di Maio M

doi

10.1517/14656560903485672

subject

Has Abstract

pub_date

2010-02-01 00:00:00

pages

321-4

issue

2

eissn

1465-6566

issn

1744-7666

journal_volume

11

pub_type

杂志文章,随机对照试验
  • Neuraminidase inhibitors as a strategy for influenza treatment: pros, cons and future perspectives.

    abstract::Introduction: Influenza represents a major public health threat worldwide. Implementation of good personal health and hygiene habits, together with vaccination, is the most effective tools to reduce influenza burden both in community and in healthcare setting. However, achieving adequate vaccination rates is challengi...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1080/14656566.2019.1626824

    authors: Bassetti M,Castaldo N,Carnelutti A

    更新日期:2019-10-01 00:00:00

  • Safinamide in the treatment of Parkinson's disease.

    abstract:IMPORTANCE OF THE FIELD:Current therapy for Parkinson's disease (PD) is primarily directed at reversing the motor symptoms that are the consequence of dopamine deficiency and includes levodopa, dopamine agonists and monoamine oxidase (MAO) B inhibitors. New drugs offering both dopaminergic and non-dopaminergic actions ...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.2010.511612

    authors: Schapira AH

    更新日期:2010-09-01 00:00:00

  • New pharmacological approaches for the treatment of alcoholism.

    abstract::Pharmacological relapse prevention in alcoholism is a rather new clinical field with few drugs being available. Acamprosate, acting predominantly via glutamatergic pathways, and the opioid receptor antagonist naltrexone, were both shown to be efficient in improving rates for continuous abstinence, and not relapsing to...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.7.17.2341

    authors: Soyka M,Roesner S

    更新日期:2006-12-01 00:00:00

  • Current treatment options to prevent perinatal transmission of herpes simplex virus.

    abstract::Neonatal herpes is a potentially devastating consequence of perinatal transmission of the herpes simplex virus (HSV), with significant morbidity and mortality. Treatment options are available, but must begin early in disease with manifestations that are often protean. Thus, preventive measures need to be optimised. An...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.4.10.1809

    authors: Leung DT,Sacks SL

    更新日期:2003-10-01 00:00:00

  • Evaluation of injection force of three insulin delivery pens.

    abstract:OBJECTIVE:Reduced injection force is among the modifications to the Next Generation FlexPen (NGFP). This force was compared with two other prefilled pens: SoloStar (SS) and KwikPen (KP). RESEARCH DESIGN/METHODS:The injection force of the pens was measured, with either a BD Micro-Fine 31G thin-wall needle, or a NovoFin...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章

    doi:10.1517/14656560903018929

    authors: Asakura T,Seino H,Kageyama M,Yohkoh N

    更新日期:2009-06-01 00:00:00

  • Treatment options for lysosomal storage disorders: developing insights.

    abstract:INTRODUCTION:Lysosomal storage disorders (LSDs) are clinically heterogeneous disorders that result primarily from lysosomal accumulation of macromolecules in various tissues. LSDs are always progressive, and often lead to severe symptoms and premature death. The identification of the underlying genetic and enzymatic de...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.2012.729039

    authors: van Gelder CM,Vollebregt AA,Plug I,van der Ploeg AT,Reuser AJ

    更新日期:2012-11-01 00:00:00

  • Platelet glycoprotein IIb/IIIa inhibitors during percutaneous coronary interventions: a pharmacological and clinical review.

    abstract::One of the most significant advances of the last decade has been the development of platelet glycoprotein (GP) IIb/IIIa receptor inhibitors. A large series of randomised, controlled clinical trials of these agents have shown a significant reduction in ischaemic events, not only in acute coronary syndrome patients, but...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.5.2.335

    authors: Anne G,Gruberg L

    更新日期:2004-02-01 00:00:00

  • Pharmacological management of renal fibrotic disease.

    abstract::Chronic kidney diseases frequently advance to end-stage renal failure, and the number of patients affected is steadily increasing worldwide. At the molecular level, progression of renal insufficiency correlates closely with ongoing pathological matrix protein expansion (i.e., renal fibrosis), in a manner independent o...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.7.4.377

    authors: Gaedeke J,Neumayer HH,Peters H

    更新日期:2006-03-01 00:00:00

  • Clopidogrel in ST-elevation myocardial infarction patients undergoing percutaneous coronary intervention.

    abstract::Clopidogrel has become a mainstay in the management of acute coronary syndrome patients over the past decade, as well as an essential component of percutaneous coronary intervention (PCI) pharmacotherapy. Until recently, no prospective study has evaluated the effectiveness of clopidogrel in the setting of an ST-segmen...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.7.12.1669

    authors: Hamdalla H,Moliterno DJ

    更新日期:2006-08-01 00:00:00

  • Current treatment options and strategies for myelodysplastic syndromes.

    abstract:BACKGROUND:The myelodysplastic syndromes (MDS) are a group of heterogeneous disorders characterized by ineffective hematopoiesis. A number of scoring systems have been developed but they are of limited value in guiding individual patient treatment decisions. OBJECTIVE:We have presented the benefits and limitations of ...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.9.10.1667

    authors: Srinivasan S,Schiffer CA

    更新日期:2008-07-01 00:00:00

  • Overview of the [corrected] travoprost /timolol BAK-free fixed combination.

    abstract:INTRODUCTION:Glaucoma is the second leading cause of blindness globally, representing a significant public health concern. More than 60 million people are affected by glaucoma worldwide; as this population ages, the number is expected to increase. Glaucoma is a collection of heterogeneous diseases sharing common clinic...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.2012.662485

    authors: Konstas AG,Quaranta L,Realini T

    更新日期:2012-04-01 00:00:00

  • Pharmacotherapy of cough-variant asthma.

    abstract::Cough-variant asthma is considered as an asthma subset in which chronic cough is the only symptom. It is believed to be more frequent and, hence, sometimes overdiagnosed in children, and shares with typical asthma eosinophilic airway inflammation and consequent bronchial hyper-responsiveness. Presently available thera...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.8.17.3021

    authors: Antoniu SA,Mihaescu T,Donner CF

    更新日期:2007-12-01 00:00:00

  • Combination strategies for pain management.

    abstract::At least two factors relating to pain management using oral analgesics suggest that combination strategies merit consideration: many pains arise from more than one physiological cause and current analgesics have adverse effect profiles that might be reduced by combination with another agent in smaller doses or with le...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.4.10.1697

    authors: Raffa RB,Clark-Vetri R,Tallarida RJ,Wertheimer AI

    更新日期:2003-10-01 00:00:00

  • Treatment options for esophageal cancer.

    abstract::There is considerable controversy over the level of evidence from randomized trials underpinning management decisions for patients presenting with localized cancer of the esophagus and esophago-gastric junction. There is also an optimism that new drugs and new approaches, including response prediction based on sequent...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656560802560237

    authors: Murphy TJ,Ravi N,Reynolds JV

    更新日期:2008-12-01 00:00:00

  • Moxonidine: some controversy.

    abstract::Initially it was considered that moxonidine, like clonidine, acted at central (2)-adrenoceptors to reduce blood pressure. With the characterisation of imidazoline binding sites distinct from (2)-adrenoceptors, the consensus became that moxonidine was acting predominantly at imidazoline I(1) receptors in the rostral ve...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.2.2.337

    authors: Doggrell SA

    更新日期:2001-02-01 00:00:00

  • Metformin & lifestyle intervention prevent Type 2 diabetes: lifestyle intervention has the greater effect.

    abstract::Diabetes mellitus is now occurring in epidemic proportions in many countries. Owing to the limited effectiveness of drug prophylaxis of diabetic complications after diabetes has developed, it may be more appropriate to investigate ways to prevent the onset of diabetes. A recent trial published by the Diabetes Preventi...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章

    doi:10.1517/14656566.3.7.1011

    authors: Doggrell SA

    更新日期:2002-07-01 00:00:00

  • Therapeutic options for Acinetobacter baumannii infections.

    abstract::Acinetobacter baumannii is an important cause of nosocomial infections, mainly in patients in intensive care units. This microorganism, although with slight differences depending on the country, presents resistance to multiple antimicrobial agents, occasionally including resistance to colistin: hence, it can be consid...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.9.4.587

    authors: Vila J,Pachón J

    更新日期:2008-03-01 00:00:00

  • Current chemotherapy options for thymic epithelial neoplasms.

    abstract::Thymomas and thymic carcinoma are rare neoplasms. Surgical resection is the cornerstone of effective therapy. Stage I disease is effectively treated by complete surgical resection. The role of radiation therapy in completely resected stage II disease remains controversial. Adjuvant radiation therapy is useful for loca...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.6.7.1169

    authors: Papadopoulos KP,Thomas CR Jr

    更新日期:2005-06-01 00:00:00

  • A review of olanzapine pamoate.

    abstract:INTRODUCTION:Olanzapine long-acting injection (OLAI), or olanzapine pamoate , is one of three second generation (SGA) antipsychotics now available in a long-acting formulation. OLAI is a microcrystalline salt of pamoic acid and olanzapine suspended in an aqueous solution that slowly dissociates into the separate compon...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章

    doi:10.1517/14656566.2012.686169

    authors: Chue P,Chue J

    更新日期:2012-08-01 00:00:00

  • Oxybutynin gel for the treatment of overactive bladder.

    abstract:INTRODUCTION:Overactive bladder (OAB) is a common condition that has a profound impact on an individual's overall health and quality of life. Muscarinic receptor antagonists are the mainstay of oral pharmacotherapy for OAB. While all of the medications in this class are significantly more effective than placebo, they a...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.2012.688953

    authors: Gomelsky A,Dmochowski RR

    更新日期:2012-06-01 00:00:00

  • Gout--what are the treatment options?

    abstract::There has been an increase in the incidence and prevalence of gout in the past several decades. A distinction needs to be made between the treatment of gout as an acute inflammatory disease and the lowering of the serum urate (SU) levels into a normal range. Treating acute gout attacks alone is not sufficient to preve...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656560902950742

    authors: Schlesinger N,Dalbeth N,Perez-Ruiz F

    更新日期:2009-06-01 00:00:00

  • Current approaches to therapy for vascular injury.

    abstract::Vascular injury is a ubiquitous phenomenon which can be both occult (such as with hyperlipidemia) and overt (such as with angioplasty). While the exact pathophysiology differs between acute and chronic atherosclerosis, both lesions can be mechanistically explained by the vasculature's exaggerated response to injury. P...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.2.5.753

    authors: Selzman CH

    更新日期:2001-05-01 00:00:00

  • The value of irbesartan in the management of hypertension.

    abstract::Elevated blood pressure levels are highly prevalent and are a major reason for cardiovascular events and thus place a significant financial burden on healthcare systems worldwide. Guidelines recommend five first-line anti-hypertensive drug classes, but compelling indications may indicate favoring one drug class over a...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656560903103820

    authors: Bramlage P,Durand-Zaleski I,Desai N,Pirk O,Hacker C

    更新日期:2009-08-01 00:00:00

  • The role of infectious agents in pulmonary and systemic vascular disease.

    abstract::With emphasis on the pulmonary circulation, three general types of vascular disease are discussed: fibroproliferative (atherosclerosis), cellular proliferative (endothelial neoplasms) and inflammatory (granulomatous vasculitis). The causes of these phenotypic responses are invariably multifactorial, but infectious age...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.2.7.1093

    authors: Egermayer P

    更新日期:2001-07-01 00:00:00

  • Pharmacotherapy for knee osteoarthritis: current and emerging therapies.

    abstract:INTRODUCTION:Osteoarthritis (OA) is the leading cause of pain, loss of function and disability in the elderly, with the knee being the most impactful joint affected. Currently, there is still no 'cure' in OA treatment. AREAS COVERED:The authors review the current and emerging therapies for knee OA including traditiona...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1080/14656566.2020.1732924

    authors: Cao P,Li Y,Tang Y,Ding C,Hunter DJ

    更新日期:2020-05-01 00:00:00

  • Current and developing synthetic pharmacotherapy for treating relapsed/refractory multiple myeloma.

    abstract:INTRODUCTION:The introduction of novel agents has significantly improved multiple myeloma (MM) patient outcome during the last two decades. MM received the most drug approvals for any one malignancy during this time period, both in the United States as well as in Europe. Areas covered: Proteasome inhibitors, immunomodu...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1080/14656566.2017.1340942

    authors: Podar K,Pecherstorfer M

    更新日期:2017-08-01 00:00:00

  • Pharmacological management of pulmonary embolism.

    abstract:INTRODUCTION:Pulmonary embolism (PE) is a common and potentially severe manifestation of venous thromboembolism. Its management has relied on anticoagulation by vitamin K antagonists (VKA) for the past fifty years. Recently, new alternative drugs have been developed and dramatically modified both the treatment of acute...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1080/14656566.2016.1268122

    authors: Gouin B,Robert-Ebadi H,Righini M,Blondon M

    更新日期:2017-01-01 00:00:00

  • Treatment advances in non-Hodgkin's lymphoma.

    abstract::Non-Hodgkin's lymphomas (NHL) encompass a heterogeneous group of lymphoid malignancies with varying natural histories and prognoses. Recent classifications for NHL have defined distinct lymphoma entities based on morphology, immunophenotype, genetic features, clonal cell lineage and clinical features. These new, more ...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.1.3.451

    authors: Tan BR,Bartlett NL

    更新日期:2000-03-01 00:00:00

  • A noninferiority confirmatory trial of prasugrel versus clopidogrel in Japanese patients with non-cardioembolic stroke: rationale and study design for a randomized controlled trial - PRASTRO-I trial.

    abstract:BACKGROUND:This comparison of PRAsugrel and clopidogrel in Japanese patients with ischemic STROke (PRASTRO)-I trial investigates the noninferiority of prasugrel to clopidogrel sulfate in the prevention of recurrence of primary events (ischemic stroke, myocardial infarction, and death from other vascular causes), and th...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1080/14656566.2018.1444029

    authors: Nagao T,Toyoda K,Kitagawa K,Kitazono T,Yamagami H,Uchiyama S,Tanahashi N,Matsumoto M,Minematsu K,Nagata I,Nishikawa M,Nanto S,Abe K,Ikeda Y,Ogawa A

    更新日期:2018-04-01 00:00:00

  • Bipolar disorders: new approaches to therapy.

    abstract::This article reviews the evidence supporting different somatic treatment strategies in the acute and maintenance treatment phases of bipolar disorder. Bipolar affective disorder is a chronic disorder with a life time incidence of 0.3 - 1.5/100 [1]. Severe affective disorder is associated with a risk of completed suici...

    journal_title:Expert opinion on pharmacotherapy

    pub_type: 杂志文章,评审

    doi:10.1517/14656566.2.4.601

    authors: Watson S,Young AH

    更新日期:2001-04-01 00:00:00