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August 2, 2026NeoplasiaOpen Access

Prophylactic folinic acid prevents pemetrexed myelosuppression: A randomized trial toward safer treatment with chemotherapy in non-small cell lung cancer

Ramon R. Contrucci Rob ter Heine Merel Tonn Jeroen Diepstraten Eric van Thiel Charlotte van Kesteren Michel M. van den Heuvel Cor van der Leest Nikki de Rouw

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Key Points

To investigate the efficacy of folinic acid prophylaxis in reducing pemetrexed-induced myelosuppression among patients with non-small cell lung cancer.
Randomized trial with 50 patients receiving pemetrexed, either with or without oral folinic acid prophylaxis.
Patients were randomized 1:1 to receive prophylaxis on days 2–4 after chemotherapy cycles.
Primary endpoint was absolute neutrophil count (ANC) after the first chemotherapy cycle.
Higher ANC observed in the folinic acid group after the first cycle (median 3.79, IQR 2.22–4.93) compared to control (1.85, IQR 1.43–3.78), with p-value < 0.05.

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Implication

Randomized trial demonstrates that folinic acid reduces myelosuppression in non-small cell lung cancer, suggesting safer chemotherapy treatment.

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Cite This Study

Contrucci et al. (2026) studied this question.

synapsesocial.com/papers/6a72e79c226790f370656cc9 https://doi.org/10.1016/j.neo.2026.101343

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Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

1A prospective phase II randomized clinical study of folic acid in the intervention of radiation esophagitis induced by concurrent chemoradiotherapy in lung cancer.2024
2Safety and efficacy of pemetrexed for patients with non-small cell lung cancer in the setting of renal impairment: a retrospective study2024
3PemToxTrial: An Observational Study of PEMetrexed-Associated Severe HematoTOXicity in Lung Adenocarcinoma with Bone MetastasesObservational Study · 2026
4Incidence of neutropenia with intrathecal pemetrexed for leptomeningeal disease associated with solid tumors – A retrospective analysisRetrospective Study · 2026
5Efbemalenograstim alfa for prophylaxis in non–small cell lung cancer patients patients with chemotherapy-induced febrile neutropenia: A randomized, multicenter, exploratory clinical trial.Clinical Trial · 2026

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Pegylated granulocyte colony-stimulating factor primary prophylaxis versus no prophylaxis in patients with unresectable pancreatic cancer treated with modified-FOLFIRINOX: a randomized, open-label, multicenter, phase 2 trial2025
Combination chemotherapy with cyclophosphamide, adriamycin, intermediate dose methotrexate, and folinic acid rescue (CAMF) in advanced lung cancer1980

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