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Kidney tubular toxicity of maintenance pemetrexed therapy

Ilya G Glezerman1, M Catherine Pietanza, Vincent Miller

  • 1Renal Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA. glezermi@mskcc.org

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|August 19, 2011
PubMed

Insights

Pemetrexed, used for lung cancer, can cause kidney disease. Patients on maintenance pemetrexed experienced kidney injury, with function remaining impaired after stopping the drug.

Area of Science:

  • Oncology
  • Nephrology
  • Pharmacology

Background:

  • Pemetrexed is a key antifolate chemotherapy agent for advanced non-small cell lung cancer.
  • Common pemetrexed toxicities include myelosuppression and neutropenia.
  • The potential for pemetrexed-induced nephrotoxicity requires further investigation.

Observation:

  • Three patients receiving maintenance pemetrexed therapy developed kidney disease.
  • Renal biopsy revealed tubulointerstitial injury, characterized by tubular simplification, shrinkage, and loss of brush border.
  • One advanced case demonstrated significant tubular atrophy.

Findings:

  • Kidney disease manifested during maintenance pemetrexed treatment.
  • Histopathological findings indicated significant tubulointerstitial damage.
  • Renal function impairment persisted post-pemetrexed discontinuation.

Implications:

  • Pemetrexed may pose a risk of kidney injury in lung cancer patients.
  • Monitoring renal function is crucial for patients on pemetrexed therapy.
  • Further research is needed to understand and mitigate pemetrexed-associated nephrotoxicity.

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