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Farshad F

A total of 607 patients received pemetrexed, pembrolizumab, and platinum every 3 weeks for 4 cycles followed by pemetrexed and pembrolizumab (n=405), or placebo, pemetrexed, and platinum every 3 weeks for 4 cycles followed by placebo and pemetrexed (n=202)

2017;49:e291

This "paradoxical response" (where treatment temporarily makes symptoms worse) includes: Numbness and tingling Shooting pains Joint pain Increased sensitivity Temporary inflammation (swelling and irritation) While these symptoms generally indicate that treatment is working (as nerves begin to repair themselves), they can be distressing for patients and may require additional treatment for comfort

Stop all activity immediately and gently stretch the affected muscle in the opposite direction of the cramp

copper accumulation from GHK-Cu is the main driver of the off period