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Pemetrexed: a novel antifolate agent enters clinical practice
Victoria Kut1, Jyoti D Patel, Athanassios Argiris
1Department of Medicine, Division of Hematology/Oncology, The Feinberg School of Medicine, Robert H Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL 60611, USA.
Expert Review of Anticancer Therapy
|July 24, 2004
Summary
Pemetrexed is a novel antifolate approved for mesothelioma and effective for non-small cell lung cancer. Its toxicity is manageable with vitamin supplementation, and it shows promise in other solid tumors.
Area of Science:
- Oncology
- Pharmacology
Background:
- Pemetrexed is a multitargeted antifolate inhibiting key enzymes in nucleic acid synthesis.
- It has gained FDA approval for advanced malignant pleural mesothelioma in combination with cisplatin.
Purpose of the Study:
- To review the efficacy and toxicity of pemetrexed in various cancers.
- To highlight its role in first-line and second-line cancer treatment.
Main Methods:
- Review of clinical trial data for pemetrexed.
- Analysis of efficacy and toxicity profiles compared to other chemotherapeutics.
Main Results:
- Pemetrexed demonstrated comparable efficacy to docetaxel in second-line non-small cell lung cancer with a better toxicity profile.
- Significant myelosuppression, a primary toxicity, is reduced by folic acid and vitamin B12 coadministration.
- Promising single-agent activity observed in Phase II trials for head and neck, breast, and colorectal cancers.
Conclusions:
- Pemetrexed is an effective agent for malignant pleural mesothelioma and non-small cell lung cancer.
- Combination regimens and further studies are investigating expanded roles for pemetrexed in solid tumor treatment.