Added by |
amaraver |
Group name |
EquipeAM |
Item Type |
Journal Article |
Title |
Evaluation of changes in renal function in PARAMOUNT: a phase III study of maintenance pemetrexed plus best supportive care versus placebo plus best supportive care after induction treatment with pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer |
Creator |
Middleton et al. |
Author |
Gary Middleton |
Author |
Cesare Gridelli |
Author |
Jean-Louis Pujol |
Author |
Martin Reck |
Author |
Rodryg Ramlau |
Author |
Barbara Parente |
Author |
Thierry Pieters |
Author |
Carla M. Visseren-Grul |
Author |
William J. John |
Author |
Annamaria Hayden Zimmermann |
Author |
Nadia Chouaki |
Author |
Luis Paz-Ares |
Abstract |
OBJECTIVES: To assess the effect of long-term pemetrexed maintenance therapy on patients' renal function.
METHODS: In the PARAMOUNT phase III trial (NCT 00789373), pemetrexed was compared with placebo as maintenance treatment in advanced nonsquamous non-small-cell lung cancer patients who completed 4 cycles of pemetrexed plus cisplatin induction therapy. To evaluate changes in renal function during pemetrexed continuation maintenance treatment, we retrospectively analyzed changes in serum creatinine (sCr), treatment-emergent adverse events, dose delays and treatment discontinuations associated with impaired renal function.
RESULTS: Creatinine clearance ?45?mL/min was required before the start of any cycle. Patients on pemetrexed maintenance had a significantly higher percentage maximum increase in sCr over baseline versus placebo for the range of ?10% to ?90% increase (p?.05). The risk of experiencing renal events leading to dose delays and discontinuations was higher with higher increases in sCr but reversible in most patients. sCr increases of ?30% and ?40% were associated with gender (female), age (<70 years) and longer exposure to pemetrexed compared with placebo. Sixteen (4%) pemetrexed patients and 1 (1%) placebo patient discontinued treatment due to drug-related renal events; 13/16 (81%) of those pemetrexed patients had sCr increases ?30% and 7/13 (54%) had pre-existing conditions and/or were receiving nephrotoxic drugs.
CONCLUSIONS: The appearance of renal events leading to dose delays and/or treatment discontinuations was associated with sCr increase of at least 30%. However, it was difficult to identify patients at a higher risk of treatment discontinuation due to a drug-related renal event based only on changes in pre-maintenance laboratory values. |
Publication |
Current Medical Research and Opinion |
Volume |
34 |
Issue |
5 |
Pages |
865-871 |
Date |
May 2018 |
Journal Abbr |
Curr Med Res Opin |
Language |
eng |
DOI |
10.1080/03007995.2018.1439462 |
ISSN |
1473-4877 |
Short Title |
Evaluation of changes in renal function in PARAMOUNT |
Library Catalog |
PubMed |
Extra |
PMID: 29424248 |
Tags |
clinic, Creatinine clearance, maintenance therapy, non-small-cell-lung cancer, renal toxicity, serum creatinine |
Date Added |
2018/11/15 - 16:12:45 |
Date Modified |
2019/05/16 - 10:34:17 |
Notes and Attachments |
PubMed entry (Attachment) |