pemetrexed

P2, N=13, Active, not recruiting, M.D. Anderson Cancer Center | Recruiting --> Active, not recruiting | N=27 --> 13

Herein, we report the first documented case of phenotypic conversion to SCLC in a patient with advanced pulmonary sarcomatoid carcinoma (PSC) who received pemetrexed, carboplatin, and camrelizumab only, with no targeted agents administered. TP53 and RET mutations may be implicated in this phenotypic transition. This case provides new insights into the biological mechanism underlying the evolution of PSC to SCLC.

Platinum/PEM/Pembro may be a therapeutic option for TTF-1-negative non-sq NSCLC with good PS and adenocarcinoma histology, although careful management of irAE is required.

After three cycles of neoadjuvant carboplatin, pemetrexed, and pembrolizumab, computed tomography (CT) scan revealed a significant response. Incorporating a POLE evaluation could improve the integrated decision-making process for patients with NSCLC in the perioperative setting. Prospective studies are warranted to validate this observation.

P1/2, N=265, Recruiting, Ellipses Pharma | Trial completion date: Jun 2027 --> Mar 2028 | Trial primary completion date: Dec 2026 --> Mar 2027

P3, N=878, Recruiting, AstraZeneca | Trial completion date: Mar 2030 --> Nov 2030 | Trial primary completion date: May 2029 --> Nov 2030

We aimed to evaluate and compare the efficacy and safety of atezolizumab, bevacizumab, carboplatin, and paclitaxel (ABCP) versus pemetrexed plus carboplatin or cisplatin (PC) in patients with progressive NSCLC harboring EGFR, ALK, or ROS1 alterations after TKI failure. ABCP significantly improved PFS compared with PC in patients with NSCLC that progressed despite prior TKI therapy. An OS benefit was observed in patients with three or more metastatic sites.

Reported PFS values were: replacement EGFR-TKI (1.9-4.4 months), platinum-pemetrexed chemotherapy (1.6-20.7 months), osimertinib plus platinum-pemetrexed (3.9-6.9 months), chemotherapy plus anti-angiogenic agents (1.8-16.8 months), and chemotherapy plus immune checkpoint inhibitors (3.8 months). Post-progression molecular testing and, where feasible, tissue re-biopsy are important to guide subsequent treatment decisions. Second-line outcomes were variable, with chemotherapy combined with anti-angiogenic agents showing numerically longer progression-free survival in a small subgroup; however, these findings are descriptive due to the small sample size and treatment heterogeneity.

P1, N=500, Recruiting, MediLink Therapeutics (Suzhou) Co., Ltd. | N=155 --> 500 | Trial completion date: Apr 2029 --> Jun 2031 | Trial primary completion date: Apr 2027 --> Jun 2031

Sequential adrenal resection revealed divergent squamous differentiation (p40+/CK5/6+; TTF-1-/Napsin-A-) with KRAS/MYC and NF-1 amplification, supporting a final diagnosis of pulmonary adenosquamous carcinoma-an aggressive NSCLC variant comprising 0.4-4% of lung malignancies.Management and OutcomeTreatment followed evidence-based, histology-guided sequencing: concurrent carboplatin-pemetrexed chemoradiation, nivolumab upon platinum resistance, and cytotoxic salvage with docetaxel followed by vinorelbine. The patient survived 42 months from diagnosis, the clinical course was shaped by adequate tissue sampling, diagnostic challenges, and multidisciplinary histology-guided treatment acquisition.ConclusionThis case underscores the diagnostic and therapeutic complexity of lung adenocarcinoma presenting with synchronous colonic metastases without a discrete parenchymal mass, compounded by intratumoral heterogeneity and phenotypic divergence across metastases. Comprehensive tissue sampling enabling serial immunohistochemical and molecular characterization, coupled with coordinated multidisciplinary management, is essential to optimize diagnostic accuracy and therapeutic sequencing in this rare and clinically challenging disease entity.

P1, N=157, Completed, BeiGene | Active, not recruiting --> Completed

P3, N=570, Not yet recruiting, CSPC Megalith Biopharmaceutical Co.,Ltd.