A case series of dose-limiting peripheral edema observed in patients treated with pemetrexed Journal Article


Authors: D'Angelo, S. P.; Kris, M. G.; Pietanza, M. C.; Rizvi, N. A.; Azzoli, C. G.
Article Title: A case series of dose-limiting peripheral edema observed in patients treated with pemetrexed
Abstract: Introduction: In the phase I and II trials, the dose-limiting toxicities of pemetrexed included neutropenia, thrombocytopenia, and fatigue. Grade 3 bilateral peripheral edema that resembled cellulitis was not commonly described. Methods: Since 2009, the Thoracic Oncology Service at Memorial Sloan Kettering Cancer Center has identified 14 patients who developed bilateral peripheral edema and erythema of the lower extremities while receiving pemetrexed chemotherapy. During this time, 489 patients with thoracic malignancy have been treated with pemetrexed. Results: There were seven men and seven women. Average age was 72 years. All patients had stage IV adenocarcinoma of the lung. The edema presented at a median of eight doses (range, 3-23 doses.) Other causative factors such as deep vein thrombosis, renal insufficiency, and congestive heart failure were excluded. Thirteen of the 14 patients required the drug to be stopped or dose lowered. Conclusion: We have collected 14 cases with lung adenocarcinoma treated with pemetrexed who developed bilateral lower extremity edema and erythema, a condition rarely described. In all cases, symptoms resolved with discontinuation or dose reduction of the drug. Patients who received corticosteroids showed improvement in their symptoms. Copyright © 2011 The International Association for the Study of Lung Cancer.
Keywords: cancer chemotherapy; clinical article; aged; prednisone; bevacizumab; cisplatin; drug dose reduction; drug withdrawal; paclitaxel; low drug dose; furosemide; cetuximab; cancer center; lung adenocarcinoma; peripheral edema; erythema; corticosteroid; pemetrexed; case study; bilateral lower extremity edema; chemotherapy toxicities; cefalexin; thorax cancer
Journal Title: Journal of Thoracic Oncology
Volume: 6
Issue: 3
ISSN: 1556-0864
Publisher: Elsevier Inc.  
Date Published: 2011-03-01
Start Page: 624
End Page: 626
Language: English
DOI: 10.1097/JTO.0b013e318207f788
PROVIDER: scopus
PUBMED: 21317741
DOI/URL:
Notes: --- - "Export Date: 23 June 2011" - "Source: Scopus"
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  1. Christopher G Azzoli
    111 Azzoli
  2. Naiyer A Rizvi
    166 Rizvi
  3. Maria C Pietanza
    122 Pietanza
  4. Sandra Pierina D'Angelo
    252 D'Angelo
  5. Mark Kris
    869 Kris