• Silvia Novello, Francisco Luis Pimentel, Jean-Yves Douillard, Mary O'Brien, Joachim von Pawel, John Eckardt, Astra M Liepa, Lorinda Simms, Carla Visseren-Grul, and Luis Paz-Ares.
• Thoracic Oncology Unit, University of Torino, San Luigi Hospital, Torino, Italy. silvia.novello@unito.it
• J Thorac Oncol. 2010 Oct 1; 5 (10): 1602-8.

IntroductionA prespecified analysis of the large, randomized, phase III study in advanced non-small cell lung cancer showed significant improvement in survival for nonsquamous patients treated with pemetrexed/cisplatin versus gemcitabine/cisplatin. Selected grade 3/4 toxicities and resource utilization favored pemetrexed in the overall population, but detailed safety results by histology have not been reported.MethodsTreated patients were included in this analysis of safety by histology. At each cycle, adverse events were assessed, and concomitant medications, transfusions, and hospitalizations were recorded. Measures were summarized by histology and compared between arms with Fisher's exact test.ResultsWhen analyzed by squamous and nonsquamous histology, safety and resource utilization for each treatment arm paralleled those of the overall population. Selected toxicities did not vary by histology. Concomitant medication use and hospitalizations were also very similar to the patterns observed in the overall population.ConclusionsAlthough previous efficacy analyses showed a significant pemetrexed treatment advantage for nonsquamous patients, results of this analysis indicate that safety and resource utilization do not vary by histology and are consistent with the overall population. The safety and resource utilization of patients treated with pemetrexed/cisplatin are predictable, reproducible, and consistent with the established favorable safety profile of pemetrexed, regardless of histology.

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