Unsuccessful rechallenge with pemetrexed after a previous radiation recall dermatitis

Lung Cancer. 2006 Dec;54(3):423-5. doi: 10.1016/j.lungcan.2006.06.021. Epub 2006 Oct 17.

Abstract

Radiation recall dermatitis is characterized by an inflammatory reaction within a previously irradiated volume after administration of a drug. Antineoplastic drugs have mainly been involved in radiation recall reactions. This phenomenon is well known but poorly understood. Many hypotheses as stem-cell depletion in the radiotherapy field, heritable mutations within surviving stem cells, local vascular changes as well as a drug hypersensitivity reaction have been proposed to explain these reactions. In this report, we describe a non-small cell lung cancer patient treated with a carboplatin plus gemcitabine combination chemotherapy as first line followed by pemetrexed as second line therapy. Twenty-five years ago, she completed radiation therapy for breast cancer. Three days after the first cycle of pemetrexed, she presented with a radiation recall dermatitis. As EGFR-staining was negative, we rechallenged the patient with pemetrexed. Unfortunately, although less intense, we faced a recurrence of the skin reaction and pemetrexed was no longer continued.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents / adverse effects*
  • Antineoplastic Agents / therapeutic use
  • Breast Neoplasms / radiotherapy
  • Carcinoma, Non-Small-Cell Lung / complications
  • Carcinoma, Non-Small-Cell Lung / drug therapy*
  • Female
  • Glutamates / adverse effects*
  • Glutamates / drug effects*
  • Glutamates / therapeutic use
  • Guanine / adverse effects
  • Guanine / analogs & derivatives*
  • Guanine / therapeutic use
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / drug therapy*
  • Pemetrexed
  • Radiodermatitis / chemically induced
  • Radiodermatitis / diagnosis*
  • Radiodermatitis / pathology

Substances

  • Antineoplastic Agents
  • Glutamates
  • Pemetrexed
  • Guanine