At the end of the treatment period, the best tumor response rate was evaluated using the same imaging technique that was used at baseline and the Response Evaluation Criteria in Solid Tumors (RECIST) were recommended [23]. The progression free survival (PFS) was defined as the time from study entry to disease progression or death. The overall survival time (OS) was the time from study entry to death due to any cause. The safety measures including adverse events, physical examinations and clinical laboratory tests (hematology, blood chemistry, hepatic functions and renal functions) were completed before each cycle. Toxicities

were graded using version 2.0 of the National Cancer Institute Common Toxicity Criteria [24]. Statistical Methods We planned Temsirolimus purchase to have up to 53 qualified patients to be enrolled in mTOR cancer a two stage sequential, non-comparative study with the possibility of stopping the study early for lack of efficacy. Nineteen qualified patients were enrolled in the first stage. If at least twelve patients achieved disease control, thirty-four additional patients were accrued. The significance

level (i.e., the probability of rejecting the Ho when it is true) is 5%. The power (i.e., the probability of rejecting Ho when the alternative hypothesis is true) is 80% [25–29]. The statistical analysis was performed using the Statistical Package for Social Science (SPSS) 17.0. Summary statistics were given for patient characteristics,

treatment administration and all safety variables. Frequencies are reported as number and percentage. Efficacy analyses and safety analyses were conducted on all patients who received at least one dose of study drug. The objective response of chemotherapy was defined with an overall best response during treatment. PFS and OS time were analyzed by means of Kaplan-Meier method. Results Between December 2005 and May 2008, a total of 53 patients entered the study. The baseline patient characteristics were listed in Table 1. The median age was 52 years (range, 34-68 years), and there were 39 male and 14 female patients. Exoribonuclease Most patients had a good performance status, but thirteen patients had ECOG performance status 2. Thirty-eight patients had stage IV tumors. Thirty-seven patients had adenocarcinoma (including 6 alveolar carcinoma patients). Fourteen patients had squamous-cell carcinoma. One patient had large cell carcinoma. One patient had mixed carcinoma. The median interval from the primary diagnosis to the beginning of the study treatment was 8.8 months. The follow-up period varied from 1 to 42 months (mean 11.3 months, median 10 months). Thirty-two patients received pemetrexed plus cisplatin chemotherapy, and twenty-one patients received pemetrexed combined with carboplatin therapy. Out of these 53 patients, 34 were treated in second line (64.2%), 15 in third line (28.3%), and 4 in fourth line (7.5%).