Pemetrexed Versus Docetaxel to Modulate Immune Environment in NSCLC Patients

Abstract

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-1β (IL-1β), IL-6, and C-reactive protein (CRP) was similar between groups. After treatment, the PT group had significantly higher interferon (IFN)-γ and tumor necrosis factor-α (TNF-α) 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-γ and TNF-α levels, and lower levels of CD4+ T cells and tumor markers than those treated with docetaxel plus cisplatin.