Long-term Administration Of Pemetrexed Raised Toxicity Of Peripheral Edema Treated With Oral Anti-diuretics

Pemetrexed has been used as maintenance therapy for non-squamous non-small-cell lung cancer. Treatment period of pemetrexed is relatively longer than that of the other cytotoxic agents. Usually acute adverse events are mild and less frequent; however, it is still unknown if the long-term administration raised toxicities. There are several reports that pemetrexed caused eye lid or peripheral edema, which package insert also described the occurrences were 5 to 20%, 20%, respectively. We investigated if pemetrexed raised occurrence of peripheral edema that was treated with anti-diuretics during the maintenance therapy. One hundred sixty nine of NSCLC patients were treated with pemetrexed in our institution. Twelve patients were administered of pemetrexed more than 10 times. Anti-diuretics were used in 52 patients (30.2%) and pemetrexed probably induced peripheral edema in 12 patients (7.1%). The rate of administration of anti-diuretics due to the peripheral edema to the patients maintained with pemetrexed in less than 6 times, 6 times and more or 12 times and more was 4.3, 13.2 and 21.7, respectively. We concluded that long-term administration of pemetrexed raised the adverse event of peripheral edema.