Activity of pemetrexed (alimta), a new antifolate, against non-small cell lung cancer

Chemotherapy for non-small cell lung cancer (NSCLC) has developed within the past decade into an important part of treatment with palliative aims as well as part of curative combined-modality treatment. Furthermore, second-line treatment has become an accepted part of the palliative approach as well. Pemetrexed (alimta) is one of the recently introduced agents that have been evaluated for efficacy against NSCLC. In single-agent phase II studies in previously untreated NSCLC, pemetrexed resulted in a response rate of around 20%. In combination with cisplatin, response rates of 40% were achieved. As a second-line single agent in-patients with early progression after first-line treatment, the response rate is 9%. Toxicity is mainly hematologic and can be reduced by supportive measures. Overall, pemetrexed is an active agent that further improves the chemotherapeutic options of physicians involved in the treatment of NSCLC.