{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:38:37Z","timestamp":1777934317063,"version":"3.51.4"},"reference-count":10,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2018,6,5]],"date-time":"2018-06-05T00:00:00Z","timestamp":1528156800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Oncol Pharm Pract"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Pemetrexed has been shown to be effective in the treatment of advanced and metastatic nonsquamous nonsmall cell lung cancer. In this population, renal insufficiency is common; however, pemetrexed is not recommended in patients with a creatinine clearance (CrCl)\u2009&lt;\u200945\u2009ml\/min due to increased myelosuppression reported in phase I trials. The primary objective of this study is to determine the safety of dose-reduced pemetrexed in patients with a CrCl\u2009&lt;\u200945\u2009ml\/min.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This is a retrospective case series describing the incidence of grade 3 or higher toxicity in patients with CrCl\u2009&lt;\u200945\u2009ml\/min treated with dose-reduced pemetrexed at The James Cancer Hospital and Solove Research Institute at The Ohio State University.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of eighteen patients were included. Seven (39%) patients experienced a grade\u2009\u2265\u20093 toxicity. Only 18% of administrations led to a grade\u2009\u2265\u20093 toxicity. Four (22%) patients had grade\u2009\u2265\u20093 hematologic toxicity; three of which were receiving concomitant platinum agents. The fourth patient had a CrCl\u2009&lt;\u200930\u2009ml\/min. No patients receiving single-agent pemetrexed with a CrCl\u2009&gt;\u200930\u2009ml\/min experienced grade\u2009\u2265\u20093 hematologic toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Dose-adjusted pemetrexed may be cautiously administered to patients with a CrCl between 30 and 45\u2009ml\/min. Extra caution is warranted in patients receiving concomitant chemotherapy with a platinum agent as well as those with a CrCl\u2009&lt;\u200930\u2009ml\/min. Pemetrexed in combination with a platinum agent should not be routinely recommended for patients with a CrCl\u2009&lt;\u200930\u2009ml\/min.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1078155218780507","type":"journal-article","created":{"date-parts":[[2018,6,6]],"date-time":"2018-06-06T02:15:08Z","timestamp":1528251308000},"page":"1125-1129","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Safety of dose-reduced pemetrexed in patients with renal insufficiency"],"prefix":"10.1177","volume":"25","author":[{"given":"Jordan","family":"Hill","sequence":"first","affiliation":[{"name":"Department of Pharmacy at The James Cancer Hospital and Solove Research Institute at The Ohio State University, Columbus, USA"},{"name":"Department of Pharmacy, West Virginia University Medicine, Morgantown, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Vargo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy at The James Cancer Hospital and Solove Research Institute at The Ohio State University, Columbus, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Pharmacy at The James Cancer Hospital and Solove Research Institute at The Ohio State University, Columbus, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Streeter","sequence":"additional","affiliation":[{"name":"Department of Pharmacy at The James Cancer Hospital and Solove Research Institute at The Ohio State University, Columbus, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David P","family":"Carbone","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Hematology and Oncology at The James Cancer Hospital and Solove Research Institute at The Ohio State University, Columbus, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2018,6,5]]},"reference":[{"key":"bibr1-1078155218780507","volume-title":"GLOBOCAN 2012 v1.0, cancer incidence and mortality worldwide: IARC CancerBase No. 11. Lyon","author":"Ferlay J"},{"key":"bibr2-1078155218780507","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0802714"},{"key":"bibr3-1078155218780507","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccm.2011.09.001"},{"key":"bibr4-1078155218780507","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.08.163"},{"key":"bibr5-1078155218780507","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2012.47.1102"},{"key":"bibr6-1078155218780507","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.0375"},{"key":"bibr7-1078155218780507","unstructured":"Alimta (pemetrexed for injection) (package insert). Indianapolis, IN: Eli Lilly and Company, 2013."},{"key":"bibr8-1078155218780507","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.00.9720"},{"key":"bibr9-1078155218780507","unstructured":"Common Terminology Criteria for Adverse Events v4.0 (CTCAE). Bethesda, MD: Cancer Therapy Evaluation Program, http:\/\/evs.nci.nih.gov\/ftp1\/CTCAE\/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf (2009, accessed)."},{"key":"bibr10-1078155218780507","doi-asserted-by":"publisher","DOI":"10.1007\/s00280-016-3078-7"}],"container-title":["Journal of Oncology Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078155218780507","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1078155218780507","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1078155218780507","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T02:18:42Z","timestamp":1777688322000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1078155218780507"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,6,5]]},"references-count":10,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2019,7]]}},"alternative-id":["10.1177\/1078155218780507"],"URL":"https:\/\/doi.org\/10.1177\/1078155218780507","relation":{},"ISSN":["1078-1552","1477-092X"],"issn-type":[{"value":"1078-1552","type":"print"},{"value":"1477-092X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,6,5]]}}}