NSCLC: B12-FAS+pemetrexed chemotherapy safe in PEMVITASTART

  • Singh N & al.
  • Cancer
  • 2 Mar 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • 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.

Study design

  • 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.

Key results

  • 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.

Limitations

  • Patients with preexisting hemoglobin levels ≤9 g/dL and those with prior anemia treatment were excluded.

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