---
title: "Risk Factors for Rash With Carboplatin–Pemetrexed and Dexamethasone in Elderly Patients"
id: "pubmed-42674687"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42674687"
content_type: "clinical_feed_article"
specialty: "Pharmacology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42674687/"
doi: "10.21873/anticanres.18369"
published_at: "2026-09-01T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Risk Factors for Rash With Carboplatin–Pemetrexed and Dexamethasone in Elderly Patients
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42674687
- **Specialty:** [Pharmacology](https://medichelpline.com/clinical-feed/pharmacology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42674687/)
- **DOI:** [10.21873/anticanres.18369](https://doi.org/10.21873%2Fanticanres.18369)
- **Published At:** 2026-09-01T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Background: Rash is a common adverse event during combination chemotherapy with **carboplatin** (CBDCA) plus **pemetrexed** (PEM); prophylactic **dexamethasone** (4 mg twice daily for 3 days) is used to reduce PEM-associated rash and for antiemetic support. - Study population: Retrospective assessment of 109 patients aged ≥65 years with thoracic cancer receiving CBDCA plus PEM with dexamethasone prophylaxis. - Primary endpoint: Factors associated with incidence of any-grade rash during the first treatment cycle. - Secondary endpoints: Factors for any-grade rash across all treatment cycles and change in eosinophil count from baseline to nearest evaluation after rash onset. - Incidence: Any-grade rash occurred in 18.3% in the first cycle (grade 1: 11.9%, grade 2: 3.7%, grade 3: 2.8%) and 20.2% across all cycles (grade 1: 12.8%, grade 2: 4.6%, grade 3: 2.8%). - Timing: Most rashes (90.9%) appeared during the first cycle. - Key finding: A history of **EGFR-TKI** treatment was associated with a lower risk of rash (adjusted OR 0.18, 95% CI 0.01–0.94, p=0.04 for first cycle; adjusted OR 0.17, 95% CI 0.01–0.94, p=0.04 for any cycle). - Eosinophils: No significant change in eosinophil levels from baseline to the closest evaluation after rash onset was found. - Conclusion: In patients aged ≥65 receiving CBDCA plus PEM with dexamethasone prophylaxis, prior **EGFR-TKI** exposure was linked to reduced rash risk; other factors and mechanistic markers (eosinophils) were not identified as significant in this cohort. - Study design note: Retrospective single-cohort analysis; details beyond reported endpoints (e.g., additional covariates assessed) were not provided in the abstract.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Department of Clinical Pharmaceutics and Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan; saito-yo@hus.ac.jp. * 2 Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan. * 3 Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan. * 4 Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan. * 5 Laboratory of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan. * PMID: **42674687** * DOI: [ 10.21873/anticanres.18369 ](https://doi.org/10.21873/anticanres.18369) Item in Clipboard # Factors Associated With Rash in Elderly Patients Receiving Carboplatin Plus Pemetrexed With Dexamethasone Prophylaxis Yoshitaka Saito et al. Anticancer Res. 2026 Sep. Show details Display options Display options Format Abstract PubMed PMID Anticancer Res Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Anticancer+Res%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Anticancer+Res%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42674687/) . 2026 Sep;46(9):5249-5258. doi: 10.21873/anticanres.18369. ### Authors [Yoshitaka Saito](https://pubmed.ncbi.nlm.nih.gov/?term=Saito+Y&cauthor_id=42674687)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42674687/#short-view-affiliation-1 "Department of Clinical Pharmaceutics and Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan; saito-yo@hus.ac.jp."), [Osamu Taniguchi](https://pubmed.ncbi.nlm.nih.gov/?term=Taniguchi+O&cauthor_id=42674687)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674687/#short-view-affiliation-2 "Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan."), [Yoh Takekuma](https://pubmed.ncbi.nlm.nih.gov/?term=Takekuma+Y&cauthor_id=42674687)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674687/#short-view-affiliation-2 "Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan."), [Jun Sakakibara-Konishi](https://pubmed.ncbi.nlm.nih.gov/?term=Sakakibara-Konishi+J&cauthor_id=42674687)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42674687/#short-view-affiliation-3 "Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan."), [Yasushi Shimizu](https://pubmed.ncbi.nlm.nih.gov/?term=Shimizu+Y&cauthor_id=42674687)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674687/#short-view-affiliation-4 "Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan."), [Ichiro Kinoshita](https://pubmed.ncbi.nlm.nih.gov/?term=Kinoshita+I&cauthor_id=42674687)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42674687/#short-view-affiliation-4 "Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan."), [Mitsuru Sugawara](https://pubmed.ncbi.nlm.nih.gov/?term=Sugawara+M&cauthor_id=42674687)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42674687/#short-view-affiliation-2 "Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan.")[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42674687/#short-view-affiliation-5 "Laboratory of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan.") ### Affiliations * 1 Department of Clinical Pharmaceutics and Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo, Japan; saito-yo@hus.ac.jp. * 2 Department of Pharmacy, Hokkaido University Hospital, Sapporo, Japan. * 3 Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan. * 4 Department of Medical Oncology, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan. * 5 Laboratory of Pharmacokinetics, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo, Japan. * PMID: **42674687** * DOI: [ 10.21873/anticanres.18369 ](https://doi.org/10.21873/anticanres.18369) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Background/aim:** Rash is a frequently observed adverse event during therapy with carboplatin (CBDCA) plus pemetrexed (PEM) and may be attributable to PEM. Dexamethasone (4 mg twice daily for 3 days) attenuates PEM-induced rash and is also recommended for managing nausea and vomiting. As the incidence of thoracic cancer is markedly higher in elderly individuals, this study aimed to identify factors for rash development during CBDCA plus PEM treatment under dexamethasone prophylaxis in patients aged ≥65 years. **Patients and methods:** Patients aged ≥65 years with thoracic cancer receiving CBDCA plus PEM-based treatment with dexamethasone prophylaxis (n=109) were retrospectively assessed. The primary endpoint was factors for the incidence of any-grade rash during the first treatment cycle. Secondary endpoints were factors for any-grade rash during any treatment cycle and change in eosinophils between the baseline and closest evaluation after symptom onset. **Results:** The incidence of any-grade rash was 18.3% (grade 1: 11.9%, grade 2: 3.7%, grade 3: 2.8%) in the first cycle and 20.2% (12.8%, 4.6%, and 2.8%, respectively) considering all cycles. Most symptoms appeared during the first cycle (90.9%). Multivariable logistic regression analyses identified a history of epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) as a factor preventive against rash development [adjusted odds ratio (95% confidence interval) of 0.18 (0.01-0.94), _p_ =0.04; and 0.17 (0.01-0.94), _p_ =0.04 for the first cycle and any treatment cycle, respectively]. The change in eosinophil level from baseline to the closest evaluation after rash development was not significant. **Conclusion:** Patients with a history of EGFR-TKI treatment are at low risk for rash development during CBDCA plus PEM chemotherapy with dexamethasone prophylaxis in patients aged ≥65 years. **Keywords:** Pemetrexed; carboplatin; dexamethasone; elderly patients; rash; risk factor. Copyright © 2026 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved. 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