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Pemetrexed in bladder, head and neck, and cervical cancers
Luis Paz-Ares1, Eva Ciruelos, Rocío García-Carbonero
1Department of Medical Oncology, Doce de Octubre University Hospital, Madrid, Spain.
Abstract:
Pemetrexed is a novel multitargeted antifolate analog. The drug has shown encouraging activity in a wide range of solid tumors, including cervix, head and neck, and bladder carcinomas, which are the focus of this review. Toxicity, particularly hematologic, is higher in patients with these tumor types than in other populations exposed to pemetrexed. Supplementation with folic acid and vitamin B(12) appears to effectively reduce the incidence of severe toxicity and may optimize the therapeutic index of pemetrexed in patient subsets with poor nutritional status. The role of this agent in the management of these and other tumor types, as a single agent or in combination, shall be determined by randomized phase III studies.
Insights
Pemetrexed shows promise for solid tumors like cervical and head and neck cancers. Supplementing with folic acid and vitamin B12 can reduce toxicity, optimizing its use in certain patients.
Area of Science:
- Oncology
- Pharmacology
Background:
- Pemetrexed is a novel multitargeted antifolate analog.
- It demonstrates activity across various solid tumors, notably cervix, head and neck, and bladder carcinomas.
Purpose of the Study:
- This review focuses on pemetrexed's efficacy and toxicity in specific solid tumors.
- To evaluate the role of nutritional supplementation in mitigating pemetrexed-induced toxicity.
Main Methods:
- Review of existing literature on pemetrexed in cervix, head and neck, and bladder cancers.
- Analysis of toxicity profiles and impact of folic acid and vitamin B12 supplementation.
Main Results:
- Pemetrexed exhibits encouraging activity in the studied tumor types.
- Hematologic toxicity is a significant concern in these patient populations.
- Folic acid and vitamin B12 supplementation effectively reduces severe toxicity.
Conclusions:
- Nutritional supplementation may optimize the therapeutic index of pemetrexed.
- Further randomized phase III studies are required to define pemetrexed's role in managing these cancers.
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