Cancers
PemToxTrial: An Observational Study of PEMetrexed-Associated Severe HematoTOXicity in Lung Adenocarcinoma with Bone Metastases
Par Christian Riedel, Christian Neumann, Arash Moghaddam et 10 autres.
Contenu en anglais
Résumé
Introduction
Pemetrexed, an antifolate, is a standard therapy for lung adenocarcinoma (LUAD). Since folic acid is vital for nucleic acid metabolism, disrupting its pathway affects both tumor cells and regenerating healthy cells. The PemToxTrial examined the impact of pemetrexed on severe hematotoxicity and mortality.
Methods
This retrospective analysis included 136 LUAD patients (UICC8 stage IVA/B) receiving palliative treatment. Ninety-two patients received pemetrexed-based therapy, while 44 received pemetrexed-free treatment (68 and 38 with immune-checkpoint inhibitors). Bone metastasis (BM) was present in 47 patients in the pemetrexed group and 22 in the comparison group. The primary endpoint was grade III–V hematotoxicity; secondary endpoints included mortality, progression-free survival (PFS), and overall survival (OS). Hematologic outcomes following a subsequent change in clinical practice were prospectively assessed in a post-implementation cohort of 15 patients with bone-metastatic LUAD receiving pemetrexed-free regimens.