Association of Graded Folic Acid Supplementation and Total Plasma Homocysteine Levels With Hematological Toxicity During First-line Treatment of Nonsquamous NSCLC Patients With Pemetrexed-based Chemotherapy.
Am J Clin Oncol
; 40(1): 75-82, 2017 02.
Article
em En
| MEDLINE
| ID: mdl-25089530
ABSTRACT
BACKGROUND:
Pemetrexed is the preferred treatment of nonsquamous non-small cell lung cancer (ns-NSCLC). Folic acid supplementation (FAS) (350 to 1000 µg daily PO) is recommended to minimize hematological toxicity (HTox). Elevated total plasma homocysteine (tpHcy) predicts increased risk of HTox with pemetrexed in absence of FAS. The current study aimed to assess prevalence of elevated tpHcy levels at baseline and after pemetrexed treatment. Association of graded tpHcy levels/FAS with toxicity was also assessed. MATERIALS ANDMETHODS:
Retrospective analysis of all ns-NSCLC patients undergoing first-line treatment with pemetrexed-containing platinum doublet over 3½ years was carried out. All eligible patients received pemetrexed (500 mg/m) and cisplatin (65 mg/m) each on D1 of a 3-week cycle. FAS was 400 µg for tpHcy< upper limit of normal (ULN), 700 µg for tpHcy 1 to 2 ULN, and 1000 µg for tpHcy>2 ULN. All patients also received oral ferrous sulphate and injectable vitamin B12. Exact 95% confidence intervals (CI) were calculated for comparison with previously published studies.RESULTS:
75.7% of 111 patients had stage IV disease. Prevalence of tpHcy levelsCONCLUSIONS:
Prevalence of elevated tpHcy levels posttreatment as compared with baseline was reduced significantly with FAS. Among ns-NSCLC patients treated with pemetrexed and with FAS of 400 to 1000 µg daily, HTox was not associated with either baseline tpHcy levels or with graded baseline FAS.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Carcinoma Pulmonar de Células não Pequenas
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Pemetrexede
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Ácido Fólico
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Hematínicos
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Homocisteína
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Neoplasias Pulmonares
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Antineoplásicos
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
Am J Clin Oncol
Ano de publicação:
2017
Tipo de documento:
Article
País de afiliação:
Índia