- Administering B-12 and folic acid supplementation (B12-FAS) and first-line pemetrexed-based chemotherapy (PEM) simultaneously, instead of the standard practice of waiting 5-7 days between treatments, was safe in patients with metastatic nonsquamous NSCLC.
Why this matters
- This is the first randomized trial of simultaneous vs delayed B12-FAS and PEM treatment.
- Open-label, randomized PEMVITASTART trial.
- 150 patients with advanced nonsquamous NSCLC received B12-FAS followed by PEM administered immediately (IA; n=77) or after a 5-7-day delay (DA; n=73).
- Funding: None.
- Thrombocytopenia of any grade was significantly higher in the IA group than the DA group (31.2% vs 16.4%; P=.04), but 7.8% of IA patients had the condition at baseline compared with 0 in the DA group.
- Grade ≥3 cytopenias were similar between groups.
- Patients with preexisting hemoglobin levels ≤9 g/dL and those with prior anemia treatment were excluded.