Author of

• 12592

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  P3.10 - Poster Session 3 - Chemotherapy (ID 210)

  • Event: WCLC 2013
  • Type: Poster Session
  • Track: Medical Oncology
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/30/2013, 09:30 - 16:30, Exhibit Hall, Ground Level

  • 12602

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    P3.10-010 - A Study of Pemetrexed monotherapy in Patients with Advanced Non-Small Cell Lung Cancer with Impaired Renal Function (ID 1011)

    09:30 - 09:30  |  Author(s): M. Asano
    • Abstract

    Background
    Pemetrexed (Alimta) plasma clearance positively correlated with glomerular filtration rate (GFR), resulting in increased drug exposures in patients with impaired renal function. In US Food and drug administration guidances, pemetrexed is not recommended for patients with a creatinine clearance (CrCl) less than 45 mL/min. Insufficient numbers of patients have been studied with creatinine clearance < 45 mL/min to give a dose recommendation. Here, we investigated the toxicity and effectiveness of pemetrexed in patients with impaired renal function.

    Methods
    Patients with nonsquamous non-small cell lung cancer who received chemotherapy with pemetrexed as a single-agent, were divided into two groups of CrCl<45 mL/min and ≥45 mL/min, and were analyzed retrospectively, between May 2009 and May 2012. Patients received a 10-minute infusion of 375 to 500mg/m[2] of pemetrexed every 3 weeks. Estimated CrCl was calculated using Cockcroft-Gault formula.

    Results
    Twenty-seven patients were ascessed in this study, 10 patients with a CrCl < 45 mL/min and 17 patients with a CrCl ≥ 45 mL/min. The rate of grade 3/4 neutropenia was higher in patients with a CrCl < 45 mL/min than ≥ 45 mL/min. There were no febrile neutropenia and treatment related death. Nonhematologic toxicities included fatigue, diarrhea, and nausea, did not correlate with renal function. Stable disease was observed in 6 patients (60%) in CrCl < 45 mL/min group, and in 12 (70%) in CrCl ≥ 45 mL/min group.

    Conclusion
    Although the risk of grade 3/4 neutropenia was higher in patients with impaired renal function (CrCl < 45mL/min) than maintained renal function (CrCl ≥ 45 mL/min), treatment with pemetrexed should be considered dose reduction in patients with impaired renal function.