title: Acute Tubular Necrosis and Interstitial Nephritis during Pemetrexed Therapy.
abstract: We report a patient with unknown primary undifferentiated carcinoma who developed acute renal failure associated with interstitial fibrosis following pemetrexed therapy. Despite drug withdrawal, renal function remained altered and the patient experienced chronic renal insufficiency. Pemetrexed disodium (Alimta) is a multitargeted antifolate agent approved by the Food and Drug Administration (FDA) for patients diagnosed with mesothelioma and non-small cell lung cancer. This drug is almost exclusively cleared by renal excretion [1]. The most common side effects are hematologic dose-limiting toxicities and nonhematologic toxicities including fatigue, diarrhea, nausea, mucositis and rash. Although few cases of renal failure have been published, no study has reported on the renal pathological findings in this setting. We present a case of acute tubular necrosis associated with interstitial fibrosis after pemetrexed therapy.
authors.affiliation: Department of Medical Oncology, Pitié-Salpêtrière Hospital, Paris, France.
authors.forename: Judith
authors.initials: J
authors.lastname: Michels
authors.forename: Jean Philippe
authors.initials: JP
authors.lastname: Spano
authors.forename: Isabelle
authors.initials: I
authors.lastname: Brocheriou
authors.forename: Gilbert
authors.initials: G
authors.lastname: Deray
authors.forename: David
authors.initials: D
authors.lastname: Khayat
authors.forename: Hassane
authors.initials: H
authors.lastname: Izzedine