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This study investigated the difference of measured values between two types of analyzer over a wider range of fractional exhaled nitric oxide （FeNO） levels than in previous reports because some asthma patients have high FeNO levels. The equation for conversion of measured FeNO levels between the two analyzers was also determined.Methods：Patients underwent assessment of FeNO for the diagnosis and management of asthma or for differential diagnosis of cough, FeNO levels were measured sequentially using both a stationary analyzer（NOA280i®, Sievers Inc, USA） and a hand-held analyzer（NIOX MINO®, Aerocrine Inc, Sweden）. FeNO levels were measured in a total of 167 subjects. Regression analysis of the FeNO data showed a strong positive correlation between values obtained with the two analyzers （r＝0.938, p＜0.0001）, and the regression line was calculated as：FeNO （NOA280i®）×0.63＋3.79＝FeNO （NIOX MINO®）. The correlation between the two analyzers was strongest at low FeNO values and it decreased as the FeNO level increased ［FeNO （NOA280i®）£50 （r＝0.730, p＜0.0001） FeNO （NOA280i®） 50 to £100 （r＝0.641, p＜0.0001）, FeNO （NOA280i®）＞100 to £150 （r＝0.607, p＝0.0008）, and FeNO （NOA280i®）＞150 （r＝0.523, p＝0.0180）］. Bland-Altman plot analysis between the two analyzers was 0.167 （95％ confidence interval＝－0.038 to 0.357, suggesting a positive difference.Some caution is needed because the correlation between the two analyzers is weaker when the FeNO level exceeds 150.

Introduction： A phase I trial was conducted to evaluate the feasibility of pemetrexed in combination with carboplatin followed by pemetrexed maintenance therapy in elderly patients with advanced non-small cell lung cancer （NSCLC）. The primary objective of this study was to determine the maximum tolerated dose （MTD） and the recommended dose （RD） of pemetrexed in combination with carboplatin.Methods：Chemotherapy-naïve elderly 13 patients （age, ≥70 years） with stage IIIB/IV non-squamous NSCLC were enrolled and received pemetrexed 500 mg/m2 and carboplatin at an area under the curve （AUC）dose of 5 mg/ml/min（level 1）or 6 mg/ml/min （level 2）. Pemetrexed with carboplatin was administered on day 1 of the 21-day cycle. The treatment schedule consisted of four cycles of pemetrexed with carboplatin. Patients who did not have progressive disease after completion of four cycles subsequently received pemetrexed maintenance therapy （500 mg/m2 every three weeks） until disease progression or unacceptable toxicity was noted.Results：Three patients were enrolled in level 1, in which no dose-limiting toxicity（DLT）was observed. The carboplatin dose was escalated to AUC 6. Two of 3 patients treated in level 2 had grade 4 thrombocytopenia of DLT. MTD was determined as level 2. Consequently, pemetrexed 500 mg/m2 with carboplatin AUC 5 was recommended as the dose for elderly patients with advanced non-squamous NSCLC. An additional 7 patients who received RD showed no DLT. Nine of 13 patients received 4 cycles of combination therapy, and 5 patients were continuously treated with pemetrexed maintenance therapy. Six patients achieved a partial response, and another 6 showed stable disease. The response rate and disease control rate were 46.2％ and 92.3％, respectively. The median progression-free survival for the enrolled patients was 134 days （95％ CI, 95 to 231 days）, and the median overall survival was 346 days （95％ CI, 151 to 549 days）.Conclusions：The combination therapy of pemetrexed 500 mg/m2 with carboplatin AUC 5 followed by pemetrexed maintenance therapy showed no severe adverse events and was feasible and well-tolerated for elderly patients with advanced non-squamous NSCLC.