Pemetrexed in the treatment of non-small-cell lung cancer and malignant pleural mesothelioma

Abstract

Lung cancer — non-small-cell (NSCLC) in 85% of patients — is currently leading cause of cancer-related mortality in Poland and worldwide. Malignant pleural mesothelioma is a rare malignancy, but prognosis
is poor. In about 60% of patients with NSCLC the disease is inoperable (locally advanced or metastatic).
Pleural mesothelioma is diagnosed in advanced stage in majority of patients. Palliative treatment of patients with NSCLC and malignant pleural mesothelioma is based on chemotherapy. Platinum-based
doublets with third generation drugs are standard in the first line treatment of advanced (metastatic) NSCLC. Pemetrexed and cisplatin-containing chemotherapy is most essential palliative management in
advanced malignant pleural mesothelioma. Among the range of recommended third-generation drugs pemetrexed is also used in the treatment NSCLC. Histology is the predictive factor for pemetrexed efficacy
in NSCLC. Pemetrexed is also used in the second-line treatment of NSCLC cancer after failure of platinum-based initial chemotherapy. The new indication for pemetrexed is maintenance treatment after
first-line chemotherapy in patients with at least disease stabilization.