導讀：肺癌患者的5年存活率與30年前相比有了很大提高，這與現代腫瘤醫學的發展和進步有密切的關系。先進儀器，使肺癌可以早檢查，早治療。與此同時，藥學水平也在不斷的提高，治療肺癌的多種分子靶向藥相繼問世。靶向治療相比傳統治療作用更準確，副作用更小，使得抗癌而不破壞機體免疫不再是空想。靶向治療已產生巨大的影響，我們期望我國能充分運用中西醫療法的優勢，為人類最終能攻克癌癥出一份力量。

藥物治療——肺癌
  
Pemetrexed聯合順鉑或卡鉑一線治療廣泛期小細胞肺癌II期隨機臨床試驗 
 　　　
Randomized Phase II Trial of Pemetrexed Combined With Either Cisplatin or Carboplatin in Untreated Extensive-Stage Small-Cell Lung Cancer
英文原文：
Mark A. Socinski, Charles Weissman, Lowell L. Hart, J. Thaddeus Beck, Janak K. Choksi, John P. Hanson, Diane Prager, Matthew J. Monberg, Zhishen Ye, Coleman K. Obasaju
Journal of Clinical Oncology, Vol 24, No 30 (October 20), 2006: pp. 4840-4847
PURPOSE: Given the activity and tolerability of pemetrexed/platinum combinations in non–small-cell lung cancer, and the success of novel therapeutic strategies employed in recent extensive-stage small-cell lung cancer (ES-SCLC) trials, a randomized phase II trial was initiated to evaluate the use of cisplatin or carboplatin plus pemetrexed in previously untreated ES-SCLC.
PATIENTS AND METHODS: Patients were randomly assigned to receive pemetrexed 500 mg/m2 plus cisplatin 75 mg/m2 or pemetrexed plus carboplatin area under the concentration curve 5. Treatment was administered once every 21 days for a maximum of six cycles. All patients received folic acid, vitamin B12, and steroid prophylaxis.
RESULTS: Between December 19, 2002, and May 17, 2004, 78 patients were enrolledonto this multicenter trial. Median age was 63 years (range, 46 to 82 years) for cisplatin/pemetrexed and 66 years (range, 47 to 75 years) for carboplatin/pemetrexed. Median survival time (MST) for cisplatin/pemetrexed was 7.6 months, with a 1-year survivorship of 33.4% and a response rate of 35% (95% CI, 20.6% to 51.7%). The MST for carboplatin/pemetrexed was 10.4 months, with a 1-year survivorship of 39.0% and a response rate of 39.5% (95% CI, 24.0 to 56.6). Median time to progression for cisplatin/pemetrexed was 4.9 months and for carboplatin/pemetrexed was 4.5 months. Median dose-intensity (actual/planned dose) was 98.94% for cisplatin and 99.95% for pemetrexed in the cisplatin/pemetrexed group and 93.21% for carboplatin and 98.50% for pemetrexed in the carboplatin/pemetrexed group. Grade 3/4 hematologic toxicities included neutropenia (15.8% v 20.0%) and thrombocytopenia (13.2% v 22.9%) in the cisplatin/pemetrexed and carboplatin/pemetrexed treatment groups, respectively.
CONCLUSION: Pemetrexed/platinum doublets had activity and appeared to be well-tolerated in first-line ES-SCLC.
 
參考譯文：　
Pemetrexed聯合順鉑或卡鉑一線治療廣泛期小細胞肺癌的II期隨機臨床試驗

目的：鑒于Pemetrexed聯合鉑類藥物治療非小細胞肺癌安全、有效，新近進行廣泛期小細胞肺癌的II期隨機臨床試驗引入了這一新的治療方案,目的是評估Pemetrexed聯合順鉑或卡鉑在未經治療的廣泛期小細胞肺癌治療中的應用。　

患者和方法：患者隨機分成兩組，分別接受培美曲塞 500 mg/m2 加 順鉑 75 mg/m2（以下簡稱順鉑組）和培美曲塞加卡鉑面積濃度曲線＜5（以下簡稱卡鉑組）治療。給藥方法為每21天為1周期，每周期給一次最大劑量藥物，共6周期。所有患者同時給予葉酸、維生素B12，類固醇預防治療。

結果：從2002年12月19日到2004年5月17日，共78名患者參加這項多中心試驗。順鉑加培美曲塞組中位年齡63歲（年齡范圍從46-82歲），卡鉑加培美曲塞組中位年齡66歲（范圍從47-75歲）。前組中位生存期為7.6個月，1年生存率為33.4%,有效率為35％。后組中位生存期為10.4個月，1年生存率為39％，有效率39.5％，順鉑組中位進展期為4.9個月，卡鉑組為4.5個月，中位最大劑量（實際應用/計劃劑量）在順鉑組，順鉑劑量為計劃劑量的98.94%，培美曲塞99.95%；卡鉑組卡鉑為93.21%，培美曲塞98.50%。兩組3~4級血液毒性反應包括中性粒細胞減少癥發生率分別為15.8%和20.0%，血小板減少癥發生率分別為13.2%和22.9%。
結論：培美曲塞聯合鉑類藥物一線治療小細胞肺癌有效且耐受良好。　
 


　　百濟新特連鎖藥業是一家經營和管理重大慢性疾病用藥的連鎖專科藥房，同時也是全國最大的專科醫藥連鎖企業。藥房擁有400多種腫瘤類藥品，囊括肺癌、肝癌、胃癌、前列腺癌、乳腺癌、結直腸癌等主流新特藥品，專業的網站為您提供腫瘤相關信息，包括腫瘤癥狀，腫瘤的治療以及腫瘤患者的生活調理等。客服中心由數十位資深藥師組成，依托400免費電話，以科學客觀的態度介紹藥品，為全國顧客提供更便捷、更專業的藥品咨詢服務。

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