Objective: This study aims to observe the efficacies and adverse reactions of modified vitamin programs before pemetrexed chemotherapy (second-line treatment) against epidermal growth factor receptor (EGFR) mutant wild-type lung adenocarcinoma.
Methods: 477 patients with IIIB, phase IV glomerular filtration rate (GFR) mutant-negative lung adenocarcinomas and performed pemetrexed chemotherapy were collected and divided into group A (167 cases, with modified program) and group B (310 cases, with traditional program). The modified program was: orally administrated 400 μg folic acid once per day and 1 day before the first-round pemetrexed chemotherapy, until the 21st day of the final administration of pemetrexed, and intramuscularly injected 500 μg vitamin B12 1 day before the first-round pemetrexed chemotherapy, and injected once 1 day before every round pemetrexed treatment.
Results: Comparison between group A and group B: mean chemotherapy cycles (4.08 vs 3.98); effectiveness rate (22.16% vs 22.90%); disease control rate (56.51% vs 55.00%); without significant difference (P > 0.05). Two groups currently all reached the median overall survival (OS). The median progression-free survival (PFS): 4.2 vs 4.1 months; OS: 12.9 vs 13.2 months, without statistical difference (P > 0.05). Such side effects between the two groups as leukopenia, neutropenia, thrombocytopenia, anemia, nausea, vomiting, diarrhea, fatigue, creatinine increasing, alanine transaminase (ALT) increasing, stomatitis, peripheral neuropathy, alopecia and rash had no significant difference (P > 0.05).
Conclusions: The modified vitamin supportive treatment could ensure the efficacy, significantly simplify, facilitate the clinical application, and increase the associated toxicities, indicating that the pemetrexed-based chemotherapy did not need to be delayed because applying the vitamin supportive treatment.
Keywords: Lung adenocarcinoma; folic acid; pemetrexed; vitamin B12.