Mandatory dexamethasone strictly monitored by pharmacists reduces the severity of pemetrexed-induced skin rash

Abstract

ObjectiveThe present study aimed to retrospectively examine the effectiveness of mandatory dexamethasone (m-DEX) strictly monitored by pharmacists collaborating with medical physicians and nurses for reducing pemetrexed (PEM)-induced skin rash in patients with non-squamous non-small-cell lung cancer (ns-NSCLC).MethodsWe compared the rash grades during the first cycle of PEM-containing regimens between patients who received m-DEX after February 2012 and those who received dexamethasone (DEX) at their physician's discretion (d-DEX) before January 2012.ResultsOf 163 patients with ns-NSCLC included in this study, 89 received d-DEX and 74 received m-DEX. The mean DEX doses the night before and the day after PEM administration were significantly higher in the m-DEX group than in the d-DEX group. The frequency of grade ≥2 skin rash was significantly lower in the m-DEX group than in the d-DEX group.ConclusionsThe use of m-DEX strictly monitored by pharmacists might significantly reduce the severity of PEM-induced skin rash.

Novel anticancers and dermatological adversities: old rivals but new challenges

“…Piérard et al suggested that a high Ki67 index could point towards cell cycle blockade versus calprotectin (MAC 387) immunopositivity of keratinocytes as a soft indictor of immunological perturbation 4. Usui et al in their study concluded that mandatory dexamethasone as premedication before pemetrexed-based therapy reduced the frequency of grade ≥2 skin rash by at least 10% 5. In past, many anti-cancer drugs are reported to be associated with dermatological adverse effects (6,7) .…”