Younger age as a risk factor for rash development in pemetrexed and carboplatin treatment with dexamethasone...

Carboplatin (CBDCA) plus pemetrexed (PEM) is one of the most effective regimens for treating thoracic cancer. Rash, which is mainly caused by PEM, occurs in 15-30% of patients. Dexamethasone administration for 3 days is recommended to manage rash, chemotherapy-induced nausea, and vomiting in this regimen. However, the nature of the PEM-induced rashes is not fully understood. Consequently, we aimed to identify the risk factors associated with rash development under dexamethasone prophylaxis in CBDCA + PEM treatment.

Patients with thoracic cancer who underwent CBDCA + PEM treatment (n = 133) were retrospectively assessed. The primary endpoint of the present study was to identify the risk factor(s) for the incidence of all-grade rash in the first cycle. Factors affecting the incidence during all treatment cycles were also evaluated.

The incidence of all-grade rash in the first cycle was 24.1%, including 16.5% for grade 1, 5.3% for grade 2, and 2.3% for grade 3, respectively. Moreover, that in all cycles, it was 27.1%, with 18.8% for grade 1, 6.0% for grade 2, and 2.3% for grade 3. Multivariate logistic regression analyses identified that age < 65 years was the singular independent risk factor for rash development in the first and all cycles (adjusted odds ratio, 2.79; 95% confidence interval, 1.17-6.67; p = 0.02 for the first cycle, 3.03, 1.29-7.09; p = 0.01 for all cycles).

Our study revealed that patients aged < 65 years were at a significantly higher risk of rash development during CBDCA + PEM chemotherapy with dexamethasone prophylaxis than patients ≥ 65 years of age.