Pemetrexed Versus Docetaxel to Modulate Immune Environment in NSCLC Patients

Background: We evaluated the effect of pemetrexed combined with cisplatin on the immune system of non-small cell lung cancer (NSCLC) patients.Methods: 376 NSCLC patients were divided into the pemetrexed plus cisplatin treatment group (PT group, n = 191) and the docetaxel plus cisplatin treatment group (DT group, n = 185). Patients in the PT group received 500 mg/m2 pemetrexed and 75 mg/m2 cisplatin. Patients in the DT group received 75 mg/m2 docetaxel and 75 mg/m2 cisplatin.Results: Carbonic anhydrase IX (CA-IX) levels, osteopontin (OPN), interleukin-10 (IL-10), IL-6, and C-reactive protein (CRP) was similar between groups. After treatment, the PT group had significantly higher interferon (IFN)--y and tumor necrosis factor-alpha (TNF-alpha) levels than the DT group. Treatment with pemetrexed plus cisplatin did not change CD4+ T cell or CD8+ T cell levels. Moreover, the PT group exhibited significantly lower neuron-specific enolase (NSE), carbohydrate antigen 199 (CA199), and carcinoembryonic antigen (CEA) levels.Conclusions: Pemetrexed plus cisplatin and docetaxel plus cisplatin showed equivalent therapeutic efficacy in NSCLC patients. Meanwhile, NSCLC patients treated with pemetrexed plus cisplatin showed higher IFN--y and TNF-alpha levels, and lower levels of CD4+ T cells and tumor markers than those treated with docetaxel plus cisplatin.

Automated summary

The study evaluated the effects of pemetrexed combined with cisplatin on the immune system of NSCLC patients. The results showed that patients treated with pemetrexed plus cisplatin had higher levels of interferon-γ and tumor necrosis factor-alpha, and lower levels of CD4+ T cells and tumor markers compared to those treated with docetaxel plus cisplatin.