title: [Assessment of risk factors for adverse events due to pemetrexed in patients with reduced renal function].
abstract: Pemetrexedis a key drug in the first and second -line therapy for non-small-cell lung cancer. It exhibits an increased area under the plasma drug concentration-time curve, and it has a prolonged half -life when administered to patients with reduced renal function, resulting in a high frequency of neutropenia. Accordingly, pemetrexed is administered to these patients with caution. Herein, we retrospectively investigated the background characteristics of patients with a creatinine clearance rate (Ccr) of<45 mL/min, who experienced severe adverse events due to pemetrexed. Thirty-eight patients with a Ccr of <45 mL/min were administered pemetrexed. Of these patients, 13 (34%) developed severe adverse events (≥Grade 3) such as neutropenia, thrombocytopenia, and nausea. Multiple logistic regression analysis revealed that a Ccr of <30 mL/min (p= 0.033) and the concomitant use of non-steroidal anti-inflammatory drugs (p=0.012) were significant risk factors for adverse events. Therefore, whenever possible, pemetrexed administration should be avoided in patients with a Ccr of <30 mL/ min and in those receiving concomitant non-steroidal anti-inflammatory drugs.
authors.affiliation: Dept. of Medical Oncology, Hiroshima City Hospital.
authors.forename: Miho
authors.initials: M
authors.lastname: Kono
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sakata
authors.forename: Takafumi
authors.initials: T
authors.lastname: Sugawara
authors.forename: Keisuke
authors.initials: K
authors.lastname: Abe
authors.forename: Shinichi
authors.initials: S
authors.lastname: Miyamori
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miura
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Hata
authors.forename: Masamoto
authors.initials: M
authors.lastname: Funaki
authors.forename: Junya
authors.initials: J
authors.lastname: Inata
authors.forename: Masashi
authors.initials: M
authors.lastname: Kanehara
authors.forename: Kouichi
authors.initials: K
authors.lastname: Hiraki
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Iwamoto
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000009:adverse effects* / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D005260:Female; D005971:Glutamates / Q000009:adverse effects* / Q000627:therapeutic use; D006147:Guanine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000503:physiopathology; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D000068437:Pemetrexed; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000964:Antimetabolites, Antineoplastic; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine