Evidence map›Paper›PMID 27863923›Full record

Trial reportClinical lung cancer2017

Pretreatment Red Blood Cell Total Folate Concentration Is Associated With Response to Pemetrexed in Stage IV Nonsquamous Non-Small-cell Lung Cancer.

Stephen J Bagley, Steven Vitale, Suhong Zhang, Charu Aggarwal, Tracey L Evans, Evan W Alley, Roger B Cohen, Corey J Langer, Ian A Blair, Anil Vachani and 1 more

Abstract readClinical Trial
In one paragraph

Trial report in Clinical lung cancer, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact, top 82% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 4 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 2 institutions in 1 country.

Stephen J BagleyAbramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA. Electronic address: stephen.bagley@uphs.upenn.edu.
Steven VitalePenn Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, PA.
Suhong ZhangCenter of Excellence in Environmental Toxicology and Center for Cancer Pharmacology, Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Charu AggarwalAbramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Tracey L EvansAbramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Evan W AlleyAbramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Roger B CohenAbramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Corey J LangerAbramson Cancer Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Ian A BlairCenter of Excellence in Environmental Toxicology and Center for Cancer Pharmacology, Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Anil VachaniDivision of Pulmonary, Allergy, and Critical Care Medicine, Thoracic Oncology Group, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Alexander S WhiteheadCenter of Excellence in Environmental Toxicology and Center for Cancer Pharmacology, Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
University of Pennsylvania · USTranslational Therapeutics (United States) · US

Funding

UNIVERSITY OF PENNSYLVANIA CAN CTR SUPPORT GRANTP30CA016520 · NCI · UNIVERSITY OF PENNSYLVANIA · PI SHELLEY L BERGER · 1985 to 2026
$222.3M
Translational Research Support CoreP30ES013508 · NIEHS · UNIVERSITY OF PENNSYLVANIA · PI Rebecca A Simmons · 2006 to 2026
$35.3M
CANCER CLINICAL EPIDEMIOLOGY TRAINING GRANTT32CA009679 · NCI · UNIVERSITY OF PENNSYLVANIA · PI Richard Aplenc, Karen Glanz · 1992 to 2026
$11.1M
NCI NIH HHS P30 CA016520NCI NIH HHS T32 CA009679NIEHS NIH HHS P30 ES013508
6 · The paper itself

Abstract

introductionPemetrexed inhibits folate-dependent enzymes involved in pyrimidine and purine synthesis. Previous studies of genetic variation in these enzymes as predictors of pemetrexed efficacy have yielded inconsistent results. We investigated whether red blood cell (RBC) total folate, a phenotypic rather than genotypic, marker of cellular folate status was associated with the response to pemetrexed-based chemotherapy in advanced nonsquamous non-small-cell lung cancer (NSCLC). MATERIALS AND

methodsWe conducted a prospective cohort study of patients with stage IV nonsquamous NSCLC receiving first-line chemotherapy containing pemetrexed. The pretreatment RBC total folate level was quantified using liquid chromatography mass spectrometry. We then compared the objective response rate (ORR) between patients with RBC total folate concentrations greater than and less than an optimal cutoff value determined from the receiver operating characteristic curve. A logistic regression model was used to adjust for age, sex, and the use of bevacizumab.

resultsThe ORR was 62% (32 of 52 patients). Receiver operating characteristic analysis was used to establish that a RBC total folate cutoff value of 364.6 nM optimally discriminated between pemetrexed responders and nonresponders. Patients with RBC total folate < 364.5 nM had an ORR of 27% compared with 71% for patients with RBC total folate > 364.5 nM (P = .01). This difference persisted after adjusting for age, sex, and the use of bevacizumab (odds ratio, 0.07; 95% confidence interval, 0.01-0.57; P = .01).

conclusionA low pretreatment RBC total folate was associated with an inferior response to pemetrexed-based chemotherapy in stage IV nonsquamous NSCLC. Larger, multicenter studies are needed to validate RBC total folate as a predictive marker of pemetrexed response.

Indexed as

AdenocarcinomaAdultAgedAged, 80 and overAntineoplastic Combined Chemotherapy ProtocolsCarboplatinCarcinoma, Non-Small-Cell LungErythrocytesFemaleFolic AcidFollow-Up StudiesHumansLung NeoplasmsMaleMiddle AgedNeoplasm StagingCarboplatinFolic AcidPemetrexedVitamin B ComplexBiomarkerChemotherapyFolic acidMTHFRPolymorphism

Identifiers

PMID27863923
PMCPMC5346447
OpenAlexW2539037901

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.