Intravenous (IV) dexamethasone prophylaxis showed efficacy in prevention of cutaneous reactions associated with pemetrexed treatment for pulmonary adenocarcinoma. Results of the analysis were recently published in the Journal of Oncology Pharmacy Practice.

The retrospective study focused on prophylaxis efficacy outcomes for patients being treated for pulmonary adenocarcinoma with pemetrexed. Patients received prophylactic dexamethasone in either the standard oral formulation (n=31) or a 20-mg IV form (n=39). Efficacy was assessed based on reports of both the incidence and intensity of cutaneous reactions throughout cycles of chemotherapy.

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Among all patients receiving oral dexamethasone, skin rashes occurred with 9 of 154 cycles (5.8%). For patients given IV dexamethasone, skin rashes happened with 10 of 114 cycles (8.9%; P =.35). Cutaneous reactions occurred most often during the first or second cycles for patients in either group.

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A total of 5 patients (16.1%) in the oral dexamethasone group and 9 patients (23.1%) in the IV dexamethasone group experienced skin rashes (P =.56).

Overall, skin rashes were considered to be exclusively of grades 1 or 2. The rashes were grade 1 in 88.9% of the cases with oral dexamethasone and in 90% of those with IV dexamethasone (P =.66). In a subgroup analysis, skin rashes were seen most often in patients treated with carboplatin with pemetrexed.

The researchers concluded that the oral and IV routes of dexamethasone administration did not show a difference in efficacy against cutaneous toxicities in this study population. Regarding IV dexamethasone prophylaxis, the authors stated in their report, “this new regimen constitutes an interesting and acceptable alternative for patients.”


  1. Groleau A, Côté J. Comparison between two premedication regimens of dexamethasone before a pemetrexed-based chemotherapy: a single-center experience study [published online August 1, 2019]. J Oncol Pharm Pract. doi: 10.1177/1078155219862040