Safety of dose-reduced pemetrexed in patients with renal insufficiency
| Autor: | Jessica Streeter, Jordan Hill, Craig A. Vargo, Michael W. Smith, David P. Carbone |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Oncology
Male medicine.medical_specialty Lung Neoplasms Population Pemetrexed 03 medical and health sciences 0302 clinical medicine Internal medicine Carcinoma Non-Small-Cell Lung medicine Humans Pharmacology (medical) In patient Renal Insufficiency Dose Reduced education Aged Retrospective Studies Aged 80 and over education.field_of_study business.industry Middle Aged 030220 oncology & carcinogenesis Female Non small cell business 030215 immunology medicine.drug |
| Zdroj: | Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners. 25(5) |
| ISSN: | 1477-092X |
| Popis: | Pemetrexed has been shown to be effective in the treatment of advanced and metastatic nonsquamous nonsmall cell lung cancer. In this population, renal insufficiency is common; however, pemetrexed is not recommended in patients with a creatinine clearance (CrCl) 45 ml/min due to increased myelosuppression reported in phase I trials. The primary objective of this study is to determine the safety of dose-reduced pemetrexed in patients with a CrCl 45 ml/min.This is a retrospective case series describing the incidence of grade 3 or higher toxicity in patients with CrCl 45 ml/min treated with dose-reduced pemetrexed at The James Cancer Hospital and Solove Research Institute at The Ohio State University.A total of eighteen patients were included. Seven (39%) patients experienced a grade ≥ 3 toxicity. Only 18% of administrations led to a grade ≥ 3 toxicity. Four (22%) patients had grade ≥ 3 hematologic toxicity; three of which were receiving concomitant platinum agents. The fourth patient had a CrCl 30 ml/min. No patients receiving single-agent pemetrexed with a CrCl 30 ml/min experienced grade ≥ 3 hematologic toxicity.Dose-adjusted pemetrexed may be cautiously administered to patients with a CrCl between 30 and 45 ml/min. Extra caution is warranted in patients receiving concomitant chemotherapy with a platinum agent as well as those with a CrCl 30 ml/min. Pemetrexed in combination with a platinum agent should not be routinely recommended for patients with a CrCl 30 ml/min. |
| Databáze: | OpenAIRE |
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