Pemetrexed versus vinorelbine treatment of advanced non-squamous non-small cell lung cancer in elderly patients

Pemetrexed and bevacizumab-containing chemotherapy for pleomorphic carcinoma of the lung

Pleomorphic carcinoma of the lung is a rare, highly malignant subtype of lung cancer, with a more aggressive clinical course compared with other types of non-small-cell lung cancer (NSCLC). Pemetrexed and bevacizumab are currently evaluated as two of the most reliable chemotherapeutic drugs for advanced NSCLC. We herein report a case of a 68- and a 46-year-old man with recurrent and chemo-naïve pleomorphic carcinoma of the lung, respectively, who were treated with a combination of carboplatin, pemetrexed and bevacizumab. The overall survival after the initiation of chemotherapy was 30 and 8 months, respectively. These cases exhibited a relatively long-term survival with chemotherapy. In the absence of definitive clinical trials, which are unlikely to be performed due to the rarity of this tumor, our cases demonstrated the potential utility of pemetrexed- and bevacizumab-containing chemotherapy. Our results also suggested that pemetrexed-containing chemotherapy may be key to the treatment of pleomorphic carcinoma of the lung.

Non-small-cell lung cancer in the elderly with an emphasis on chemotherapy in the adjuvant and metastatic disease settings

SUMMARY 

Most lung cancer patients in the USA are older than 65 years of age, and yet oncologists continue to struggle with how best to treat these older patients. This article reviews the medical management of non-small-cell lung cancer in older patients with a focus on decision-making with respect to chemotherapy in the adjuvant setting and metastatic disease settings. In these two settings, chemotherapy as a single-modality intervention can provide a major positive impact. Nonetheless, a relative dearth of evidence in these settings underscores the need to summarize the available data in an effort to make patient counseling easier for healthcare providers and to make decision-making easier for patients and their families.