Prophylactic folinic acid prevents pemetrexed myelosuppression: A randomized trial toward safer treatment with chemotherapy in non-small cell lung cancer.
NeoplasiaAug 1, 2026 (epub)
Ramon Contrucci, Rob Ter Heine, Merel Tonn et al.
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In 30 seconds
This randomized controlled trial evaluated the effect of folinic acid prophylaxis on myelosuppression in 50 patients with non-small cell lung cancer receiving pemetrexed. The study found that patients receiving folinic acid had a higher median absolute neutrophil count (ANC) after the first chemotherapy cycle (3.79 vs 1.85; p < 0.001), indicating a protective effect against myelosuppression.
Key findings
- Folinic acid group had a median ANC of 3.79 compared to 1.85 in the control group after the first cycle.
- The study included 50 patients randomized to receive either folinic acid or no prophylaxis.
- 26% of patients typically experience severe myelosuppression with pemetrexed.
- Folinic acid was administered on days 2-4 after each chemotherapy cycle.
Why it matters
Preventing myelosuppression is crucial in chemotherapy, especially for frail patients. This study suggests that folinic acid may enhance the safety of pemetrexed treatment, potentially allowing more patients to receive effective therapy without severe side effects.