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Table 3: Dose Reduction for Pemetrexed (single-agent or in combination) and Cisplatin Neurotoxicity Discontinuation Recommendation: Pemetrexed therapy should be discontinued if a patient experiences any hematologic or nonhematologic Grade 3 or 4 toxicity after 2 dose reductions or immediately if grade 3 or 4 neurotoxicity is observed

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Its mechanism of action is similar to that of non-steroidal anti-inflammatory drugs (NSAIDs)

Changes in thyroid function tests are generally not observed, despite theoretical concerns based on animal studies showing thyroid C-cell effects