The use of second-line therapy was similar, at 31% in the pemetrexed arm and 29.5% in the combination arm. Docetaxel was most commonly used among the pemetrexed-plus-carboplatin patients (30% vs. 19%), whereas carboplatin was more common in the single-agent pemetrexed arm (31% vs. 15%).
Toxicity was mild, although the combination arm had slightly more grade 3/4 anemia (11.7% vs. 3.9%) and neutropenia (5.8% vs. 1%). Nonhematologic toxicity was largely absent. Dyspnea was present with combination and single-agent therapy (5.8% vs. 10.8%), but "was likely due to underlying disease."
There were four treatment-related deaths in the combination arm from renal failure, sepsis, pneumonia, and thrombocytopenia and none in the single-agent pemetrexed arm (P = .121), Dr. Lilenbaum reported.
Dr. Lilenbaum reported research funding from Eli Lilly, and a coauthor reported serving as a consultant or advisor for Lilly. Dr. Kalemkerian reported research funding from Lilly.