The emerging role of pemetrexed for the treatment of malignant mesothelioma.
Malignant mesothelioma is a devastating disease with an onset 20 to 60 years after exposure to asbestos. Although most cytotoxic agents have been evaluated for the treatment of mesothelioma, few single agents have consistently yielded response rates above 20%. Antimetabolites are the most active drugs against mesothelioma, and of these, the antifolate group is the most widely studied and effective. Pemetrexed (Alimta), a new antifolate, may be more active because of its different mechanism of action. Several clinical trials have evaluated pemetrexed alone and in combination with a platinum agent for patients with malignant mesothelioma. A pivotal phase III trial has demonstrated that combination chemotherapy with pemetrexed and cisplatin improves survival, response rate, pulmonary function, and quality of life compared with single-agent cisplatin. Additional trials are evaluating pemetrexed in the neoadjuvant setting and in combination with other cytotoxic and targeted agents.
Kindler
Hedy Lee
HL
University of Chicago, Chicago, Illinois 60637-1463, USA.
D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005971:Glutamates / Q000627:therapeutic use*; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008654:Mesothelioma / Q000188:drug therapy*; D000068437:Pemetrexed; D013940:Thymidylate Synthase / Q000037:antagonists & inhibitors
D000964:Antimetabolites, Antineoplastic; D005971:Glutamates; D000068437:Pemetrexed; D006147:Guanine; D013940:Thymidylate Synthase