title: Single-dose dexamethasone for the prevention of pemetrexed associated cutaneous adverse reactions.
abstract: Pemetrexed (Alimta®) is a novel anti-folate antimetabolite agent that is used in combination with cisplatin for the treatment of patients with unresectable malignant pleural mesothelioma and as a single agent or in combination with cisplatin for patients with locally advanced or metastatic non-small-cell-lung-cancer. Cutaneous adverse reactions are common side effects of pemetrexed for which the manufacturer recommends 3-day premedication with dexamethasone 4 mg by mouth twice daily-(the day before, the day of, and the day after treatment). Patients' adherence to this premedication regimen is of concern. We report 14 cases of metastatic non-small-cell-lung-cancer patients who were premedicated with a single dose of dexamethasone 20 mg prior to pemetrexed or pemetrexed-based chemotherapy. None of these patients reported a grade 3 or above skin reactions over the course of their treatments. These findings suggest that a single dose of dexamethasone 20 mg may be an alternative premedication regimen in patients with metastatic non small cell lung cancer receiving pemetrexed or pemetrexed-based chemotherapy.
authors.affiliation: Department of Medicine, Appalachian Regional Healthcare Cancer Center, Hazard, KY, USA.
authors.forename: Raymond
authors.initials: R
authors.lastname: Elsoueidi
authors.affiliation: Department of Clinical Pharmacy, University of California, San Francisco, CA, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lander
authors.affiliation: Stanford Cancer Institute, Stanford, CA, USA ericha@stanford.edu.
authors.forename: Elie M
authors.initials: EM
authors.lastname: Richa
authors.affiliation: Department of Pharmacy practice, Raabe College of Pharmacy, Ohio Northern University, Ada, OH, USA.
authors.forename: Eyob D
authors.initials: ED
authors.lastname: Adane
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy / Q000453:epidemiology; D003907:Dexamethasone / Q000008:administration & dosage*; D003875:Drug Eruptions / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D000068437:Pemetrexed / Q000009:adverse effects*; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents; D005938:Glucocorticoids; D000068437:Pemetrexed; D003907:Dexamethasone
keywords: Dexamethasone; pemetrexed; rash; single dose