{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T22:43:22Z","timestamp":1777934602444,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T00:00:00Z","timestamp":1659398400000},"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":[[2023,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Oral folic acid supplementation is essential for patients treated with pemetrexed, to prevent the risk of severe hematologic toxicity. In case of intestinal absorption disorder, no recommendations exist for intravenous folic acid supplementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>\n                      We describe a 74-year-old patient with multimetastatic non-small-cell lung adenocarcinoma, receiving first-line chemotherapy with carboplatin AUC5, pemetrexed 500\u2005mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      and pembrolizumab 200\u2005mg intravenously every 3 weeks. The patient presented neglected celiac disease, resulting in malabsorption syndrome with iron and folic acid deficiency. The question was how to administer folic acid supplementation during the pemetrexed-based chemotherapy.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Management and outcomes<\/jats:title>\n                    <jats:p>Intravenous injection of 200\u2005mg levoleucovorin on day 1 of cycle 1 of pemetrexed-based chemotherapy was administered and well tolerated. During the second cycle, the levoleucovorin perfusion was not renewed by omission. The patient was hospitalized for 7 days because of febrile aplasia. Piperacillin\u2013tazobactam was started, and then switched to amoxicillin\u2013clavulanate plus ciprofloxacin. After this episode of post-chemotherapy febrile aplasia, it was decided to systematically supplement the patient with intravenous levoleucovorin, with blood folate concentration monitoring at each cycle. At 16 months after start of treatment, the patient was in complete remission, indicating that the immune-chemotherapy was effective, with no further febrile neutropenia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion\/conclusion<\/jats:title>\n                    <jats:p>\n                      This case report highlights intravenous levoleucovorin supplementation as an alternative to oral folic acid if needed during pemetrexed\n                      <jats:bold>\u2013<\/jats:bold>\n                      antifolate-based chemotherapy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10781552221117734","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T00:34:12Z","timestamp":1659486852000},"page":"750-754","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Intravenous route for folate supplementation in a patient with celiac disease treated by pemetrexed-based chemotherapy for non-small-cell lung cancer"],"prefix":"10.1177","volume":"29","author":[{"given":"Marie","family":"Beaurain","sequence":"first","affiliation":[{"name":"Hospices Civils de Lyon, Groupement Hospitalier Sud, Unit\u00e9 de Pharmacie Clinique Oncologique, Pierre-B\u00e9nite, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Rioufol","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Groupement Hospitalier Sud, Unit\u00e9 de Pharmacie Clinique Oncologique, Pierre-B\u00e9nite, France"},{"name":"Universit\u00e9 Lyon 1- EA 3738, CICLY Centre pour l'Innovation en Canc\u00e9rologie de Lyon, Lyon, Oullins cedex F-69921, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Vantard","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Groupement Hospitalier Sud, Unit\u00e9 de Pharmacie Clinique Oncologique, Pierre-B\u00e9nite, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandre","family":"Teixeira","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Groupement Hospitalier Sud, Unit\u00e9 de Pharmacie Clinique Oncologique, Pierre-B\u00e9nite, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amandine","family":"Baudouin","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Groupement Hospitalier Sud, Unit\u00e9 de Pharmacie Clinique Oncologique, Pierre-B\u00e9nite, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chloe","family":"Herledan","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Groupement Hospitalier Sud, Unit\u00e9 de Pharmacie Clinique Oncologique, Pierre-B\u00e9nite, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierre-Jean","family":"Souquet","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Groupement Hospitalier Sud, Service de Pneumologie Aigue Sp\u00e9cialis\u00e9e et Canc\u00e9rologie Thoracique, Pierre-B\u00e9nite, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastien","family":"Couraud","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Lyon 1- EA 3738, CICLY Centre pour l'Innovation en Canc\u00e9rologie de Lyon, Lyon, Oullins cedex F-69921, France"},{"name":"Hospices Civils de Lyon, Groupement Hospitalier Sud, Service de Pneumologie Aigue Sp\u00e9cialis\u00e9e et Canc\u00e9rologie Thoracique, Pierre-B\u00e9nite, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9181-4231","authenticated-orcid":false,"given":"Florence","family":"Ranchon","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Groupement Hospitalier Sud, Unit\u00e9 de Pharmacie Clinique Oncologique, Pierre-B\u00e9nite, France"},{"name":"Universit\u00e9 Lyon 1- EA 3738, CICLY Centre pour l'Innovation en Canc\u00e9rologie de Lyon, Lyon, Oullins cedex F-69921, France"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,8,2]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.03136"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3816\/CLC.2004.s.003"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/sonc.2002.37461"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.6-4-363"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.3816\/CLC.2002.s.004"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1053\/sonc.2002.37465"},{"key":"e_1_3_2_8_2","unstructured":"FDA. 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