Total Plasma Homocysteine Level Assessment and Timing of Folate/B12 Supplementation Prior to Initiation of Pemetrexed-Based Chemotherapy for Nonsquamous Non-Small Cell Lung Cancer Patients: An Irrelevant Investigation, an Unnecessary Delay, or Both?

Abstract

Usefulness of total plasma homocysteine for predicting toxicity from and optimal duration of folate and vitamin B₁₂ supplementation prior to initiation of pemetrexed-based chemotherapy both remain debatable issues following publication of recent data that challenge conventional protocols followed for the same. Randomized trials are needed in an attempt to simplify supportive care schedule during administration of pemetrexed-based chemotherapy for non-squamous NSCLC.