Pemetrexed caused kidney injury

[Goingcuckoo]

My husband had 6 months of immunotherapy which didn't work. Then 6 rounds of carboplatin and pemetrexed followed by maintenance pemetrexed. The long term use of the pemetrexed has caused kidney injury (AKI 3). He was hospitalised for 7 days on plasma lyte. His eGFR is now only 39 (creatinine 169) and it looks like he won't be able to carry on with the pemetrexed. Has anyone else had similar problems and is there anything to be offered as an alternative to pemetrexed. As far as we know the pemetrexed has kept his disease 'stable'. He has an appointment with the oncologist in a few weeks time to discuss what next.

Thanks for any input.

[RoyCastleHelpline Partner Ask the Nurse Roy Castle]

Hi,

The oncologist will assess your husbands’ renal function at his next appointment and will discuss with him whether or not he should continue with the pemetrexed treatment. You could ask if reducing the dose of pemetrexed would have an effect on its toxicity.

Kind regards,

All the team at the Roy Castle helpline.

[Bow-19]

I have a different type of lung cancer to your husband but at the start of my treatment I had cisplatin and permatrexed, then permatrexed maintenance. I had to stop permatrexed maintenance as GFR in early twenties. I then went on to a targeted drug suitable for my type of cancer. Gradually my GFR has improved it was recently fifty one. I now see a renal physician every 6 to 8 months who monitors my function and takes an average of the readings over the year.

Have you asked about the next treatment for your husband? Or clinical trials. It might be worth doing a list of questions for your next appointment.

Wishing your husband all the best x

[Goingcuckoo in reply to Bow-19]

Thank you for your answer. The oncologist wants my husband to go to nuclear med for an injection (?) and the items needed for a 24 hour urine test. We'll then see the onc again in two weeks and then he'll tell us what the results of the urine test were and what will happen re the chemo (reduced dose or,,??? different chemo). Bit up in the air now and husband a bit down as he's now 4 weeks with no chemo. However recent bone and CT scan shows stable disease.

What is this injection and 24 hour urine test. How does it tell how your kidneys are doing. His AKI is still high 2.

Thank you

[Bow-19 in reply to Goingcuckoo]

Glad that you have a plan. I don’t know exactly what they are doing with your husband. Could you chat with the lung cancer nurse and ask her or the Consultant at your next appointment? Or ask questions when your husband goes to Nuclear Medicine? I know when I have had Nuclear Medicine injection then I have had a scan. The injection has allowed them to see what was happening in the area that they scanned, it could be the same with your husband but worth asking questions.

I too like your husband have had periods of time without treatment due to toxicity. I had a six week period last year and numerous four week periods too.

Try to do nice things while you are waiting for the results, if you can

[Goingcuckoo in reply to Bow-19]

Thank you Bow.

Hopefully won't have to wait too long for answers. It's encouraging to know that it's 'okay-ish' to miss a treatment ot two.

Keep on keeping on. X

[Bow-19 in reply to Goingcuckoo]

Wishing you all the best too xx