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Published on: July 25, 2020

Clinical activity of pemetrexed: a multitargeted antifolate anticancer agent

Benjamin Solomon1, Paul A Bunn

  • 1University of Colorado Cancer Center, Aurora, CO 80045, USA.

Future Oncology (London, England)
|March 25, 2006
PubMed

Insights

Pemetrexed, an antifolate anticancer drug, shows efficacy in treating lung and mesothelioma cancers. Supplementation with folic acid and vitamin B12 reduces its toxicities without impacting effectiveness.

Area of Science:

  • Oncology
  • Pharmacology
  • Biochemistry

Background:

  • Pemetrexed is a novel antifolate anticancer agent targeting essential enzymes for DNA and RNA synthesis.
  • Initial studies indicated significant hematologic and non-hematologic toxicities associated with pemetrexed treatment.

Purpose of the Study:

  • To evaluate the efficacy and toxicity profile of pemetrexed in various cancer types.
  • To determine the impact of folic acid and vitamin B12 supplementation on pemetrexed-related toxicities.

Main Methods:

  • Review of Phase III clinical trials and studies involving pemetrexed.
  • Analysis of pemetrexed's mechanism of action and folate-dependent enzyme inhibition.
  • Assessment of toxicity data in conjunction with patient supplementation protocols.

Main Results:

  • Pemetrexed is effective as a single agent in second-line non-small cell lung cancer treatment.
  • Pemetrexed combined with cisplatin is effective for unresectable malignant pleural mesothelioma.
  • Folic acid and vitamin B12 supplementation significantly reduces pemetrexed-induced toxicities without compromising efficacy.
  • Pemetrexed demonstrates activity in colorectal, pancreatic, breast, and urothelial tumors.

Conclusions:

  • Pemetrexed is an established treatment for non-small cell lung cancer and malignant pleural mesothelioma.
  • Routine supplementation with folic acid and vitamin B12 is crucial for managing pemetrexed toxicity.
  • Pemetrexed holds potential for broader application across various solid tumors.

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