Prevention of Pemetrexed-Induced Rash Using Low-Dose Corticosteroids: A Phase II Study

Takumi Sakurada, Hiroshi Nokihara, Tadashi Koga, Yoshito Zamami, Mitsuhiro Goda, Kenta Yagi, Hirofumi Hamano, Fuka Aizawa, Hirokazu Ogino, Seidai Sato, Yasushi Kirino, Hisatsugu Goto, Yasuhiko Nishioka, Keisuke Ishizawa

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Background: Rash eruptions are a common side-effect of pemetrexed, for which the administration of 8 mg/day of dexamethasone for 3 days from the day preceding pemetrexed administration is recommended. This study aimed to prospectively assess the effectiveness of prophylactic administration of low-dose dexamethasone for pemetrexed-induced rashes. Methods: This single-arm, phase II study recruited patients with non-squamous non–small cell lung cancer and malignant pleural mesothelioma scheduled to receive chemotherapy including pemetrexed. Patients received 2 mg of dexamethasone daily from days 2 to 6 after chemotherapy with pemetrexed. The primary endpoint was the 3-week incidence of rash eruptions. Results: Twenty-five patients were enrolled between September 2017 and May 2019. The incidence of rash after 3 weeks was 16.7%. Rashes erupted mainly on the upper half of the body, such as the chest and neck, and were of grades 1 and 2 in 2 patients each. No rashes of grade 3 or higher were observed, and there were no adverse events associated with additional corticosteroids. Conclusion: Prophylactic administration of low-dose dexamethasone for 5 days from the day after pemetrexed administration resulted in a milder incidence and severity of rash. These findings may provide a standard preventative strategy for pemetrexed-induced rashes. (Trial identifier: UMIN000025666).

Original languageEnglish
Pages (from-to)E554-E560
Issue number7
Publication statusPublished - Jun 2022


  • Rash prevention
  • low-dose dexamethasone
  • malignant pleural mesothelioma
  • non-squamous non–small cell lung cancer
  • pemetrexed

ASJC Scopus subject areas

  • General Medicine


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