Which agent can cause pulmonary edema and requires pre-treatment with dexamethasone?

Dexamethasone is administered as a pre-treatment for certain chemotherapy agents to mitigate specific side effects. In this case, docetaxel is the agent that can lead to pulmonary edema, a potentially serious side effect characterized by excess fluid in the lungs. This risk arises because docetaxel can cause changes in vascular permeability or aggravate capillary leak syndrome, resulting in fluid accumulation in the pulmonary tissues.

By administering dexamethasone before docetaxel treatment, healthcare providers aim to reduce the inflammatory response and stabilize the vascular integrity, minimizing the likelihood of pulmonary edema. This practice aligns with evidence-based protocols that address the specific adverse effects associated with docetaxel.

The other agents listed, while they may have their own distinct side effects, do not typically require dexamethasone for the prevention of pulmonary edema. Vincristine tends to be associated with neurotoxicity, vinorelbine primarily affects bone marrow function and may cause neutropenia, and cisplatin is known for nephrotoxicity and nausea rather than pulmonary complications necessitating dexamethasone pre-treatment.